title: Creation and Validation of a Simulator for Neonatal Brain Ultrasonography: A Pilot Study.
abstract: Historically, skills training in performing brain ultrasonography has been limited to hours of scanning infants for lack of adequate synthetic models or alternatives. The aim of this study was to create a simulator and determine its utility as an educational tool in teaching the skills that can be used in performing brain ultrasonography on infants.
  
  
  
  A brain ultrasonography simulator was created using a combination of multi-modality imaging, three-dimensional printing, material and acoustic engineering, and sculpting and molding. Radiology residents participated prior to their pediatric rotation. The study included (1) an initial questionnaire and resident creation of three coronal images using the simulator; (2) brain ultrasonography lecture; (3) hands-on simulator practice; and (4) a follow-up questionnaire and re-creation of the same three coronal images on the simulator. A blinded radiologist scored the quality of the pre- and post-training images using metrics including symmetry of the images and inclusion of predetermined landmarks. Wilcoxon rank-sum test was used to compare pre- and post-training questionnaire rankings and image quality scores.
  
  
  
  Ten residents participated in the study. Analysis of pre- and post-training rankings showed improvements in technical knowledge and confidence, and reduction in anxiety in performing brain ultrasonography. Objective measures of image quality likewise improved. Mean reported value score for simulator training was high across participants who reported perceived improvements in scanning skills and enjoyment from simulator use, with interest in additional practice on the simulator and recommendations for its use.
  
  
  
  This pilot study supports the use of a simulator in teaching radiology residents the skills that can be used to perform brain ultrasonography.
authors: Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115; Harvard Medical School, Boston, Massachusetts. Electronic address: andy.tsai@childrens.harvard.edu.
authors: Andy
authors: A
authors: Tsai
authors: Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115; Harvard Medical School, Boston, Massachusetts.
authors: Carol E
authors: CE
authors: Barnewolt
authors: Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115; Harvard Medical School, Boston, Massachusetts; Boston Children's Hospital Simulator Program, Boston, Massachusetts.
authors: Sanjay P
authors: SP
authors: Prabhu
authors: Boston Children's Hospital Simulator Program, Boston, Massachusetts.
authors: Reimi
authors: R
authors: Yonekura
authors: Boston Children's Hospital Simulator Program, Boston, Massachusetts.
authors: Andrew
authors: A
authors: Hosmer
authors: Boston Children's Hospital Simulator Program, Boston, Massachusetts.
authors: Noah E
authors: NE
authors: Schulz
authors: Harvard Medical School, Boston, Massachusetts; Boston Children's Hospital Simulator Program, Boston, Massachusetts; Department of Anesthesiology, Perioperative and Pain Medicine, Division of Critical Care, Boston Children's Hospital, Boston, Massachusetts.
authors: Peter H
authors: PH
authors: Weinstock
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008953:Models, Anatomic; D010865:Pilot Projects; D011871:Radiology / Q000193:education*; D000066908:Simulation Training / Q000379:methods / Q000592:standards*; D014463:Ultrasonography
keywords: Brain ultrasonography; neurosonography; resident education; simulation training; ultrasound phantom