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Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
Published on: August 9, 2024
Education Research: Simulator-Based Training in Transcranial Doppler Ultrasound: Enhancing Competency in a Critical
Aidan Shev1, Florence Sheehan1, Ziao Yin1
1Medicine, University of Washington, Seattle.
Background And Objectives:
Transcranial Doppler (TCD) ultrasound is recommended for measuring cerebral blood flow velocity to guide therapeutic intervention in patients with cerebrovascular diseases. However, the widespread use of TCD is hampered by a shortage of trained practitioners. This study evaluated the efficacy of a simulator-based curriculum in teaching novices the foundational skill to perform TCD insonation.
Methods:
We developed a curriculum on a novel simulator that incorporates interactive practice with real-time feedback. We assessed change in the skill levels of medical and premedical students without previous exposure to TCD from pretraining and posttraining tests. Psychomotor skill was assessed based on accuracy in insonating the middle cerebral, anterior cerebral, ophthalmic, basilar, and vertebral arteries. Cognitive skill (knowledge) was assessed using multiple-choice questions (MCQs).
Results:
Training significantly improved skill: the correct insonation rate increased from 16 ± 24% (95% CI 9%-23%) on the pretest to 61 ± 34% (95% CI 52%-70%) on the posttest (N = 56, p < 0.0001, Cohen d = 1.5). First-attempt accuracy improved from 15 ± 23% (95% CI 9%-21%) to 49 ± 31% (95% CI 41%-57%) (N = 56, p < 0.0001, Cohen d = 0.9). Knowledge increased markedly, with MCQs answered correctly rising from 7 ± 26% (95% CI 0%-14%) to 64 ± 19% (95% CI 59%-69%) (p < 0.0001, Cohen d = 2.5). The course, including pre-test and posttests, was completed in 2.6 ± 1.0 hours.
Discussion:
Simulator-based training rapidly improved the ability of novices to locate intracranial arteries for measurement of blood flow velocity. The data support the employment of simulator-based training as a foundational step to help alleviate the shortage of trained providers. The simulator's self-directed practice allows for scalable, standardized training.
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