title: Ultrasound during Critical Care Simulation: A Randomized Crossover Study.
abstract: OBJECTIVE
  We sought to compare two ultrasound simulation interventions used during critical care simulation. The primary outcome was trainee and instructor preference for either intervention. Secondary outcomes included the identification of strengths and weaknesses of each intervention as well as overall merits of ultrasound simulation during high-fidelity, critical care simulation. The populations of interest included emergency medicine trainees and physicians.
  
  
  METHODS
  This was a randomized crossover study with two ultrasound simulation interventions. 25 trainees and eight emergency physician instructors participated in critical-care simulation sessions. Instructors were involved in session debriefing and feedback. Pre- and post-intervention responses were analyzed for statistically significant differences using t test analyses. Qualitative data underwent thematic analysis and triangulation.
  
  
  RESULTS
  Both trainees and instructors deemed ultrasound simulation valuable by allowing trainees to demonstrate knowledge of indications, correct image interpretation, and clinical integration (p<0.05). Trainees described increased motivation to develop and use ultrasound skills. The edus2 was the preferred intervention, as it enabled functional fidelity and the integration of ultrasound into resuscitation choreography. Instructors preferred the edus2, as it facilitated better assessment of trainees' skills, thus influencing feedback.
  
  
  CONCLUSIONS
  These findings support the use of ultrasound simulation during critical care simulations. The increased functional fidelity associated with edus2 suggests that it is the preferred intervention. Further study of the impact on clinical performance is warranted.
authors: *College of Medicine.
authors: Paul A
authors: PA
authors: Olszynski
authors: ‡Royal London Hospital,London,UK.
authors: Tim
authors: T
authors: Harris
authors: †College of Education,University of Saskatchewan,Saskatoon,SK.
authors: Patrick
authors: P
authors: Renihan
authors: *College of Medicine.
authors: Marcel
authors: M
authors: D'Eon
authors: *College of Medicine.
authors: Kalyani
authors: K
authors: Premkumar
mesh_terms: D002983:Clinical Competence; D003422:Critical Care / Q000379:methods*; D018592:Cross-Over Studies; D004503:Education, Medical, Graduate / Q000379:methods; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D008348:Manikins; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*
keywords: Point of Care Ultrasound; critical care; simulation