title: Simulation-based learning of transesophageal echocardiography in cardiothoracic surgical trainees: A prospective, randomized study.
abstract: OBJECTIVE
  The Intercollegiate Surgical Curriculum now recommends that cardiac surgical trainees should be able to understand and interpret transesophageal echocardiography images. However, cardiac surgical trainees receive limited formal transesophageal echocardiography training. The objective of this study was to assess the impact of simulation-based teaching versus more traditional operating room teaching on transesophageal echocardiography knowledge in cardiac surgical trainees.
  
  
  METHODS
  A total of 25 cardiac surgical trainees with no formal transesophageal echocardiography learning experience were randomly assigned by computer to a study group receiving simulation-based transesophageal echocardiography teaching via the Heartworks (Inventive Medical, London, UK) simulator (n = 12) or a control group receiving transesophageal echocardiography teaching during elective cardiac surgery (n = 13). Each subject undertook a video-based test composed of 20 multiple choice questions on standard transesophageal echocardiography views before and after teaching.
  
  
  RESULTS
  There was no significant difference in the pretest scores between the 2 groups (P = .89). After transesophageal echocardiography teaching, subjects within each group demonstrated a statistically significant improvement in transesophageal echocardiography knowledge. Although the subjects within the simulation group outperformed their counterparts in the operating room teaching group in the post-test scores, this difference was not significant (P = .14).
  
  
  CONCLUSIONS
  Despite the familiarity with transesophageal echocardiography images during surgery, subjects in the simulation group performed at least as well as those in the operating room group. Surgical trainees will benefit from formal transesophageal echocardiography teaching incorporated into their training via either learning method.
authors.affiliation: Department of Cardiothoracic Surgery, St George's Hospital, London, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Smelt
authors.affiliation: Cardiothoracic Anesthesia, St George's Hospital, London, United Kingdom.
authors.forename: Carlos
authors.initials: C
authors.lastname: Corredor
authors.affiliation: Cardiothoracic Anesthesia, St George's Hospital, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Edsell
authors.affiliation: Cardiothoracic Anesthesia, St George's Hospital, London, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Fletcher
authors.affiliation: Department of Cardiothoracic Surgery, St George's Hospital, London, United Kingdom. Electronic address: marjan.jahangiri@stgeorges.nhs.uk.
authors.forename: Marjan
authors.initials: M
authors.lastname: Jahangiri
authors.affiliation: Cardiothoracic Anesthesia, St George's Hospital, London, United Kingdom.
authors.forename: Vivek
authors.initials: V
authors.lastname: Sharma
mesh_terms: D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D017548:Echocardiography, Transesophageal; D004501:Education, Medical / Q000379:methods; D006801:Humans; D011446:Prospective Studies; D016037:Single-Blind Method; D013903:Thoracic Surgery / Q000193:education*
keywords: computer simulation; medical education; transesophageal echocardiography