Simulation-based Longitudinal Ultrasound Training for Critical Care Physicians: A Prospective Single-center...

This study aimed to evaluate the training outcomes and early transfer of ultrasound to the clinical environment of a simulation-based longitudinal ultrasound training program for critical care physicians in a single-center intensive care unit.

We designed a simulation-based longitudinal ultrasound training for emergency and intensive care residents. The course lasts for 6 months per session, including theoretical classes, practice with simulators and real human models, learning of critical care ultrasound processes and protocols, and finally clinical application. A total of 164 physicians have received training through this program. We evaluated learner satisfaction, theoretical knowledge and practical performance both before and after training, as well as process-based indicators of clinical application and transfer of ultrasound skills into the clinical environment.

Across all 10 survey items, 81.3% to 100% of trainees responded "agree" or "strongly agree," with the highest ratings observed for the usefulness of theoretical courses and the relevance of content to clinical work. Post-training assessments showed significant improvements in theoretical examination (median difference=24, 95% CI [23.3, 26.6], W=13,366), abnormal image interpretation (median difference=36, 95% CI [32.7, 36.7], W=13,041), and operational skills (median difference=30, 95% CI [28.7, 31.3], W=13,366) (all P <0.05). Median scores significantly improved post-training compared with baseline: clinical case assessment scores increased from 48 (IQR: 38, 55) to 76 (IQR: 72 to 84); case analysis from 11 (IQR: 8 to 15) to 21 (IQR: 17 to 26); and image interpretation from 4 (IQR: 2 to 7) to 16 (IQR 13 to 18) (all P <0.05). During clinical practice, a total of 956 critical care ultrasound examinations were performed. Of these, 415 examinations (43.41%) provided additional diagnostic clarification. Overall, 789 examinations (82.53%) generated ultrasound findings that supported, refined, or contextualized ongoing diagnostic assessment or clinical decision-making.

Our longitudinal ultrasound training program strengthens foundational knowledge and enhances clinical application of critical care ultrasound. However, this single-center study lacks a comparator arm and long-term patient outcome evaluation. Future multicenter studies should validate these findings, compare training methodologies, and assess the impact of critical care ultrasound on patient morbidity and mortality.