Effect of Simulation Training on Cognitive Performance Using Transesophageal Echocardiography

Simulation is used in anesthesia training to reinforce didactic learning. The authors hypothesized that knowledge acquisition in the use of transesophageal echocardiography (TEE) could be accomplished better through the use of a simulator than with online or web-based learning. A total of 71 student registered nurse anesthetists were randomly assigned to either web-based or simulator-based TEE training. Using the same rubric, each group was instructed to use 11 views to identify 12 different cardiac structures. In addition, 15 cardiac abnormalities ("pathologies") were identified through either the simulator or a web-based link. The effect of the interventions were measured using a video-based (ExamSoft) assessment to validate improved knowledge of cardiac structures, recognition of ultrasonographic views, and identification of cardiac pathology. Although both groups demonstrated significant improvement, students who trained with the simulator scored higher than the web-based group, 69.4 vs 42.3 (P < .01). Scores were compared using the Mann-Whitney test and 2-tailed t tests. Implementation of TEE training using either modality improved TEE-related knowledge, and both are recommended as a supplement to conventional didactic training.