title: Providing initial transthoracic echocardiography training for anesthesiologists: simulator training is not inferior to live training.
abstract: 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.
  
  
  METHODS
  Prospective, randomized trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Forty-six anesthesia residents, fellows, and faculty.
  
  
  METHODS
  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.
  
  
  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 non-inferiority 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.
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address: tedrich@partners.org.
authors.forename: Thomas
authors.initials: T
authors.lastname: Edrich
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Raghu R
authors.initials: RR
authors.lastname: Seethala
authors.affiliation: Department of Medicine Division of Cardiology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Olenchock
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Annette K
authors.initials: AK
authors.lastname: Mizuguchi
authors.affiliation: Department of Medicine Division of Cardiology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Rivero
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Sascha S
authors.initials: SS
authors.lastname: Beutler
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: John A
authors.initials: JA
authors.lastname: Fox
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Frendl
mesh_terms: D000776:Anesthesiology / Q000193:education*; D003198:Computer Simulation; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies
keywords: echocardiography; education; point-of-care; ultrasound