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Comparative Analysis of Simulated versus Live Patient-Based FAST (Focused Assessment With Sonography for Trauma)
Yen-Yi Juo1, Chi Quach2, Jonathan Hiatt2
1Department of Surgery, David Geffen School of Medicine at the University of California, Los Angeles, California; Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, California.
Objective:
To investigate whether simulated patient (SP)-based training has comparable efficacy as live patient (LP)-based training in teaching Focused Abdominal Sonography for Trauma (FAST) knowledge and skill competencies to surgical residents.
Design:
A randomized pretest/intervention/posttest controlled study design was employed to compare the participants' performance in written and practical examinations regarding FAST examination after SP-based versus LP-based training.
Setting:
University-based general residency program at a single institution.
Participants:
A total of 29 general surgery residents of various training levels and sonographic experience were recruited by convenience sampling.
Results:
There was no correlation between subjects' baseline training level or sonographic experience with either the posttest-pretest score difference or the percentage of subjects getting all 4 windows with adequate quality. There was no significant difference between the improvement in written posttest-pretest scores for SP and LP group, which were 33 ± 9.6 and 31 ± 6.8 (p = 0.40), respectively. With regard to performance-based learning efficacy, a statistically higher proportion of subjects were able to obtain all 4 windows with adequate quality among the LP than the SP group (6/8 vs 1/8, p = 0.01).
Conclusion:
SP- and LP-based FAST training for surgical residents were associated with similar knowledge-based competency acquisition, but residents receiving LP-based training were better at acquiring adequate FAST windows on live patients. Simulation training appeared to be a valid adjunct to LP practice but cannot replace LP training. Future investigations on how to improve simulation fidelity and its training efficacy for skill-based competencies are warranted.
