Training Thoracic Ultrasound Skills: A Randomized Controlled Trial of Simulation-Based Training versus Training on Healthy Volunteers

Respiration. 2021;100(1):34-43. doi: 10.1159/000509298. Epub 2021 Jan 15.

Abstract

Introduction: As ultrasound becomes more accessible, the use of point-of-care ultrasound examinations performed by clinicians has increased. Sufficient theoretical and practical skills are prerequisites to integrate thoracic ultrasound into a clinical setting and to use it as supplement in the clinical decision-making. Recommendations on how to educate and train clinicians for these ultrasound examinations are debated, and simulation-based training may improve clinical performance.

Objectives: The aim of this study was to explore the effect of simulation-based training in thoracic ultrasound compared to training on healthy volunteers.

Method: A total of 66 physicians with no previous experience in thoracic ultrasound completed a training program and assessment of competences from November 2018 to May 2019. After a theoretical session in ultrasound physics, sonoanatomy, and thoracic ultrasound, the physicians were randomized into one of three groups for practical training: (1) simulation-based training, (2) training on a healthy volunteer, or (3) no training (control group). Primary outcome was difference in the clinical performance score after the training period.

Results: Using a multiple comparison, ANOVA with Bonferroni correction for multiplicity, there was no statistical significant difference between the two trained groups' performance score: 45.1 points versus 41.9 points (minimum 17 points, maximum 68 points; p = 0.38). The simulation-based training group scored significantly higher than the control group without hands-on training, 36.7 points (p = 0.009).

Conclusions: The use of simulation-based training in thoracic ultrasound does not improve the clinical performance score compared to conventional training on healthy volunteers. As focused, thoracic ultrasound is a relatively uncomplicated practical procedure when taught; focus should mainly be on the theoretical part and the supervised clinical training in a curriculum. However, simulation can be used instead or as an add-on to training on simulated patients.

Keywords: Chest ultrasound; Education; Simulation; Training; Ultrasound.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Clinical Competence
  • Computer Simulation*
  • Curriculum
  • Education* / methods
  • Education* / standards
  • Education, Medical, Continuing* / methods
  • Education, Medical, Continuing* / standards
  • Educational Measurement
  • Healthy Volunteers
  • Humans
  • Outcome Assessment, Health Care
  • Point-of-Care Testing
  • Program Evaluation
  • Respiratory Tract Diseases / diagnosis*
  • Simulation Training / methods*
  • Thoracic Diseases / diagnosis
  • Ultrasonography* / methods
  • Ultrasonography* / standards