title: Sustained effect of simulation-based ultrasound training on clinical performance: a randomized trial.
abstract: OBJECTIVE
  To study the effect of initial simulation-based transvaginal sonography (TVS) training compared with clinical training only, on the clinical performance of residents in obstetrics and gynecology (Ob-Gyn), assessed 2 months into their residency.
  
  
  METHODS
  In a randomized study, new Ob-Gyn residents (n = 33) with no prior ultrasound experience were recruited from three teaching hospitals. Participants were allocated to either simulation-based training followed by clinical training (intervention group; n = 18) or clinical training only (control group; n = 15). The simulation-based training was performed using a virtual-reality TVS simulator until an expert performance level was attained, and was followed by training on a pelvic mannequin. After 2 months of clinical training, one TVS examination was recorded for assessment of each resident's clinical performance (n = 26). Two ultrasound experts blinded to group allocation rated the scans using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale.
  
  
  RESULTS
  During the 2 months of clinical training, participants in the intervention and control groups completed an average ± SD of 58 ± 41 and 63 ± 47 scans, respectively (P = 0.67). In the subsequent clinical performance test, the intervention group achieved higher OSAUS scores than did the control group (mean score, 59.1% vs 37.6%, respectively; P < 0.001). A greater proportion of the intervention group passed a pre-established pass/fail level than did controls (85.7% vs 8.3%, respectively; P < 0.001).
  
  
  CONCLUSIONS
  Simulation-based ultrasound training leads to substantial improvement in clinical performance that is sustained after 2 months of clinical training. © 2015 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
authors.affiliation: Centre for Clinical Education, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.|Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: M G
authors.initials: MG
authors.lastname: Tolsgaard
authors.affiliation: Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Ringsted
authors.affiliation: Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: E
authors.initials: E
authors.lastname: Dreisler
authors.affiliation: Department of Obstetrics and Gynecology, Nordsjaelland Hospital Hillerød, University of Copenhagen, Hillerød, Denmark.
authors.forename: L N
authors.initials: LN
authors.lastname: Nørgaard
authors.affiliation: Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J H
authors.initials: JH
authors.lastname: Petersen
authors.affiliation: Centre for Clinical Education, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.|Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: M E
authors.initials: ME
authors.lastname: Madsen
authors.affiliation: Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.|Department of Obstetrics and Gynecology, Naestved Hospital, University of Copenhagen, Naestved, Denmark.
authors.forename: N L C
authors.initials: NL
authors.lastname: Freiesleben
authors.affiliation: Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: J L
authors.initials: JL
authors.lastname: Sørensen
authors.affiliation: Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Tabor
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003718:Denmark; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D015588:Observer Variation; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D000066908:Simulation Training; D016037:Single-Blind Method; D016216:Ultrasonography, Prenatal
keywords: medical education; simulation-based medical education; simulation-based ultrasound training; transvaginal; ultrasound assessment; ultrasound competence