Simulator training improves ultrasound scanning performance on patients: a randomized controlled trial.

Abstract

Simulation-based mastery training may improve clinical performance. The aim of this study was to determine the effect of simulation-based mastery training on clinical performance in abdominal diagnostic ultrasound for radiology residents. This study was a multicenter randomized controlled trial registered at clinicaltrials.gov (identifier: NCT02921867) and reported using the Consolidated Standards of Reporting Trials (CONSORT) statement. Twenty radiology residents from 10 different hospitals were included in the study. Participants were randomized into two groups: (1) simulator-based training until passing a validated test scored by a blinded reviewer or (2) no intervention prior to standard clinical ultrasound training on patients. All scans performed during the first 6weeks of clinical ultrasound training were scored. The primary outcome was performance scores assessed using Objective Structured Assessment of Ultrasound Skills (OSAUS). An exponential learning curve was fitted for the OSAUS score for the two groups using non-linear regression with random variation. Confidence intervals were calculated based on the variation between individual learning curves. After randomization, eleven residents completed the simulation intervention and nine received standard clinical training. The simulation group participants attended two to seven training sessions using between 6 and 17h of simulation-based training. The performance score for the simulation group was significantly higher for the first 29 scans compared to that for the non-simulation group, such that scores reached approximately the same level after 49 and 77 scans, respectively. We showed improved performance in diagnostic ultrasound scanning on patients after simulation-based mastery learning for radiology residents. NCT02921867 KEY POINTS: • Improvement in scanning performance on patients is seen after simulation-based mastery learning in diagnostic abdominal ultrasound. • Simulation-based mastery learning can prevent patients from bearing the burden of the initial steep part of trainees' learning curve.