Intensive Simulation Training in Lower Limb Arterial Duplex Scanning Leads to Skills Transfer in Real-World Scenario

To train novices to perform an abbreviated duplex lower limb ultrasound scan using simulation training and assess real-world skills transference.

Novices undertook 3 days of simulation training. Their progress was assessed using the Duplex Ultrasound Objective Structured Assessment of Technical Skills (DUOSATS) for simulation and Cumulative Imaging Score (CIS). A final assessment day was held to assess DUOSATS for simulation and real patient scanning, CIS, cumulative diagnostic accuracy, and sections A and B of the Society of Vascular Technology examination. MSc students in vascular ultrasound were also assessed for comparison.

A total of 17 novices and 7 MSc students with 3-month training participated. Novices improved DUOSATS for simulation scores between days 1, 3, and 4: 18 (17-19) vs 27 (25-28) vs 30 (28-32), (median [interquartile range], p < 0.001). Novices improved in CIS between days 1 and 3: 10 (10-13) vs 21 (19-21), p < 0.001, with a decline on day 4: 15.3 (11.3-18.3), p < 0.001. On the final assessment day, there were no significant differences between novices and MSc students in: DUOSATS for simulation scores (30 [28-32] vs 31 [6-31.5], p = 0.85); DUOSATS for patient assessment (31 [28.7-33.7] vs 26.7 [24.5-35.7], p = 0.41); CIS (15.3 [11.3-18.7] vs 20.7 [12.3-22.2], p = 0.2), respectively. However, novices performed better in section B of the Society of Vascular Technology examination compared with MSc students (72.9% vs 54.3%, p < 0.001). Novices also demonstrated a higher diagnostic accuracy when compared with MSc students (65.7% of arterial segments correctly assessed vs 47.6%, respectively [p = 0.044]).

Intensive simulation of 3-day training achieved real patient-based assessments that were comparable to MSc students who were 3 months into their traditional training program.