title: Impact of online transesophageal echocardiographic simulation on learning to navigate the 20 standard views.
abstract: OBJECTIVE
  To overcome a challenge in transesophageal echocardiographic (TEE) training, an online virtual TEE simulation was developed that allows the user to navigate among the 20 standard views. The TEE probe position and ultrasound plane movements on a 3-dimensional heart model were displayed with the corresponding TEE video recording as the probe was moved among the views.
  
  
  METHODS
  This study evaluated the educational benefit of the virtual TEE application using a pretest/post-test design.
  
  
  METHODS
  Single academic teaching hospital.
  
  
  METHODS
  Ten postgraduate physician volunteers who were novice echocardiographers.
  
  
  METHODS
  In a controlled environment, 10 study subjects completed a 20 multiple-choice question pretest, used the simulation for 1 hour, and then completed a 20 multiple-choice question post-test. Percentages of correct answers for each test were recorded for each subject.
  
  
  RESULTS
  The hypothesis that the median improvement in the number of questions correctly answered was different from 0 was tested with a related-samples Wilcoxon signed-rank test. A p value <0.05 was considered significant. A 1-hour exposure to the virtual TEE simulation produced a significant improvement (p = 0.005) in the post-test score (median 80%) compared with the pretest score (median 20%).
  
  
  CONCLUSIONS
  Using the virtual TEE simulation for 1 hour significantly improves the trainees' knowledge of navigation among the 20 standard TEE views. This application freely is available on the Internet and will be a useful adjunct to TEE training programs.
authors.affiliation: Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada. annette.vegas@uhn.ca
authors.forename: Annette
authors.initials: A
authors.lastname: Vegas
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Meineri
authors.forename: Angela
authors.initials: A
authors.lastname: Jerath
authors.forename: Michael
authors.initials: M
authors.lastname: Corrin
authors.forename: Candice
authors.initials: C
authors.lastname: Silversides
authors.forename: Gordon
authors.initials: G
authors.lastname: Tait
mesh_terms: D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D003196:Computer Graphics; D003198:Computer Simulation; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D020407:Internet; D015203:Reproducibility of Results