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Training in transvaginal sonography using pelvic ultrasound simulators versus live models: a randomized controlled
James H Moak1, Shannon R Larese, John P Riordan
1Dr. Moak is assistant professor, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia. Ms. Larese formerly served as teaching sonographer, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia. She is currently based in Charlottesville, Virginia, where she serves as clinical education specialist with Phillips Healthcare. Dr. Riordan is assistant professor, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia. Dr. Sudhir is assistant professor, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia. Dr. Yan is associate professor of biostatistics, Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia.
Purpose:
To compare pelvic ultrasound simulators (PSs) with live models (LMs) for training in transvaginal sonography (TVS).
Method:
The authors conducted a prospective, randomized controlled trial of 145 eligible medical students trained in TVS in 2011-2012 with either a PS or an LM. A patient educator was used for LM training. Simulated intrauterine and ectopic pregnancy models were used for PS training. Students were tested using a standardized patient who evaluated their professionalism. A proctor, blinded to training type, scored their scanning technique. Digital images were saved for blinded review. Students rated their training using a Likert scale (0 = not very well; 10 = very well). The primary outcome measure was students' overall performance on a 40-point assessment tool for professionalism, scanning technique, and image acquisition. Poisson regression and Student t test were used for comparisons.
Results:
A total of 134 students participated (62 trained using a PS; 72 using an LM). Mean overall test scores were 56% for the PS group and 69% for the LM group (P = .001). A significant difference was identified in scanning technique (PS, 60% versus LM, 73%; P = .001) and image acquisition (PS, 37% versus LM, 59%; P = .001). None was observed for professionalism. The PS group rated their training experience at 4.4, whereas the LM group rated theirs at 6.2 (P < .001).
Conclusions:
Simulators do not perform as well as LMs for training novices in TVS, but they may be useful as an adjunct to LM training.
