Providing Initial Transthoracic Echocardiography Training for Anesthesiologists: Simulator Training Is Not Inferior to Live Training

Objective: Transthoracic echocardiography (TTE) is finding increased use in anesthesia and critical care. Efficient options for training anesthesiologists should be explored. Simulator mannequins allow for training of manual acquisition and image recognition skills and may be suitable due to ease of scheduling. The authors tested the hypothesis that training with a simulator would not be inferior to training using a live volunteer. Design: Prospective, randomized trial. Setting: University hospital. Participants: Forty-six anesthesia residents, fellows, and faculty. Interventions: After preparation with a written and video tutorial, study subjects received 80 minutes of TTE training using either a simulator or live volunteer. Practical and written tests were completed before and after training to assess improvement in manual image acquisition skills and theoretic knowledge. The written test was repeated 4 weeks later. Measurements and Main Results: Performance in the practical image-acquisition test improved significantly after training using both the live volunteer and the simulator, improving by 4.0 and 4.3 points out of 15, respectively. Simulator training was found not to be inferior to live training, with a mean difference of -0.30 points and 95% confidence intervals that did not cross the predefined noninferiority margin. Performance in the written retention test also improved significantly immediately after training for both groups but declined similarly upon repeat testing 4 weeks later. Conclusions: When providing initial TTE training to anesthesiologists, training using a simulator was not inferior to using live volunteers. (c) 2014 Elsevier Inc. All rights reserved.