OC14.03: Long‐term effect of simulation‐based training on clinical performance: a randomised trial

Abstract

Simulation-based ultrasound training may be an effective adjunct to early clinical training. However, the long-term effects of simulation-based training on clinical performances are largely unknown. Hence, the objective of this study was to explore the effects of simulation-based transvaginal ultrasound training (intervention) compared to clinical training alone (control) on the technical quality of scans performed by ultrasound novices after two months of clinical training. In a randomised superiority trial, 26 new OB/GYN residents without prior ultrasound experience were included from three different hospitals. Participants were randomised to simulation-based training or clinical training alone. The simulation-based training was done on a virtual reality ultrasound simulator (Scantrainer, Medaphor) until an expert performance criterion was reached. This was followed by a 30 minutes session on basic knobology using a silicon phantom (Bluephantom, CAE). After two months of clinical practice, one transvaginal ultrasound scan was recorded for all participants (transfer test). Two blinded ultrasound experts rated the scans using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. Main effects of training, hospital allocation, and interaction between hospital and training were assessed using a 2-way ANOVA test. Of the 26 included participants, 14 were randomized to the intervention group and 12 to the control group. The intervention group used mean 195 minutes (SD 34.8 minutes) to attain the expert performance level during the simulation-based practice. On the transfer test the intervention group scored mean 59.1% (SD 9.3) and the control group 37.3% (SD 11.8) (p < 0.001; Cohen's d = 2.1). There was no significant hospital effect or interaction between training and hospital (p > 0.05). Simulation-based ultrasound training leads to large effects on subsequent clinical performances that are sustained after two months of clinical training.