The impact of high-fidelity simulation-based ultrasound training on skills acquisition and clinical performance
Compiled by MedaPhor based on studies by Madsen et al and Tolsgard et al
Ultrasound is increasingly being used in many fields of medicine, but is highly operator dependent. Training is traditionally time and resource intensive and associated with long learning curves, whilst inadequate training can compromise patient safety.
Simulation-based ultrasound skills learning offers the potential to significantly enhance training programmes, by reducing demand on valuable resources and improving the quality of training provided. However, to date there has been limited evidence of skills transfer from simulation-based learning to clinical performance.Read full publication
A cost model to determine the cost viability of replacing clinical training with simulation training
G Carolan-Rees and AF Ray
The aim of this study was to produce an economic cost model comparing the use of the Medaphor ScanTrainer virtual reality training simulator for obstetrics and gynaecology ultrasound to achieve basic competence, with the traditional training method. A literature search and survey of expert opinion were used to identify resources used in training. An executable model was produced in Excel. The model showed a cost saving for a clinic using the ScanTrainer of £7114 per annum. The uncertainties of the model were explored and it was found to be robust. Threshold values for the key drivers of the model were identified. Using the ScanTrainer is cost saving for clinics with at least two trainees per year to train, if it would take at least six lists to train them using the traditional training method and if a traditional training list has at least two fewer patients than a standard list.
The full study was published in Ultrasound, a journal published by Sage Publishing, on 10th January 2015. Please click here to read the full study.Read full publication
Sustained effect of simulation-based ultrasound training on clinical performance: A randomized trial
Martin G. Tolsgaard, Charlotte Ringsted, Eva Dreisler, Lone N. Nørgaard, Jørgen H. Petersen, Mette E. Madsen, Nina L.C. Freiesleben, Jette L. Sørensen, Ann Tabor
The objective was to study the effect of initial simulation-based transvaginal ultrasound training compared to only clinical training on the clinical performances of residents in Obstetrics and Gynecology (OB-GYN) measured at two months into the residency.
In a randomized study, new residents in OB-GYN (N = 33) without prior ultrasound experience were included from three teaching hospitals. Participants were allocated to simulation-based training and subsequent clinical training (n = 18) or only clinical training (n = 15). The simulation-based training was performed on a virtual-reality transvaginal ultrasound simulator until an expert performance level was attained followed by training on a pelvic mannequin. After two months of clinical training, one transvaginal ultrasound scan was recorded for assessment of participants’ clinical performance. Two blinded ultrasound experts rated the scans using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale.
During the two months of clinical training, participants in the intervention and control group completed an average of 57 (SD 41) and 63 (SD 47) scans, respectively (p = 0.67). On the subsequent clinical performance test the intervention group achieved higher OSAUS-scores than the control group (mean 59.1% vs. 37.6%; p < 0.001). A greater proportion of intervention group participants (85.7%) passed a pre-established pass/fail level compared to the controls (8.3%), p < 0.001.
Simulation-based ultrasound training leads to substantial improvements in clinical performances that are sustained after two months of clinical training. http://www.ClinicalTrials.gov Identifier NCT01895868.
The full study was published in UOG Journal, a journal published by the International Society of Ultrasound in Obstetrics and Gynecology, on 8th January 2015. Please click here to download the full study.Read full publication
Assessment of performance and learning curves on a virtual reality ultrasound simulator
Mette E. Madsen, Lars Konge, Lone N. Nørgaard, Ann Tabor, Charlotte Ringsted, Åse K. Klemmensen, Bent Ottesen, Martin G. Tolsgaard
A new study into the impact of ultrasound skills training using the ScanTrainer TVS (Transvaginal) simulator has concluded that novices’ performances improved with practice and that their learning curves reached the level of expert performance after between three and four hours of simulator training. The study gives powerful support to the effectiveness of ScanTrainer simulation training in early phase ultrasound skills acquisition.Read full publication
A proposed new clinical assessment framework for diagnostic medical ultrasound students
Ultrasound education is an area which is currently being reviewed in many HEIs, as these programmes are expensive to administer for the relatively low numbers of students involved. Within ultrasound education, rigorous assessment of clinical competence is an area which is particularly expensive to undertake, and methods used in many training programmes are potentially unsustainable for HEIs in the current economic climate. A new framework is therefore proposed, which has recently been accredited within a HEI ultrasound training programme by the Consortium for the Accreditation of Sonographic Education (CASE), and has been piloted during 2013. One of the components of this approach is the incorporation of an ultrasound simulator, which will help to standardise assessments and ensure students are assessed over a range of pathologies, rather than only those randomly presenting on the day of assessment.Read full publication