Focus Assessed Simulator Training in Transthoracic Echo for undergraduate Medical Students—Results from the FateSim Randomized Controlled Trial

Background: Today, echocardiography is the central imaging procedure in modern cardiac medicine. However, the requirements for a valid and precise echocardiographic examination are high. To acquire basic competencies in this diagnostic method, special training and a large number of self-performed examinations are necessary, which also find reflection in the certification requirements of the specialist societies (e.g., European Association of Cardiovascular Imaging (EACVI)) as well as in the specialist training in cardiac surgery.

The primary aim of this study is to investigate the quality of ultrasound training already in students and to examine the use of simulators and different learning formats.

Methods: This unicentric prospective randomized controlled trial was designed as an extracurricular workshop to teach third-year students the protocol of focused transthoracic echocardiography (FATE), comparing simulator training with subject training. A total of 144 students were included. Two groups were randomized, one was trained on the simulator and the other on the subject. A theory test was administered before and after the training (T1, T2). The practical test after the theoretical training included two tests, one on the simulator and one on the subject.

Results: In the theoretical test (T1) the subject group performed better than the simulator group (p = 0.01). After the training there was no difference in the theory test (T2) results (p = 0.41). Both groups had an increase in knowledge and benefited from the training. In the practical exam on the simulator, both groups performed equally well (p = 0.893). In the exam on the subject the group trained on the simulator performed significantly poorer than the comparison group trained on the subject (p < 0.001).

Conclusion: An objective training success could be determined; both the simulator training and the training on the subject proved to be effective. However, the transfer of the knowledge acquired on the simulator to the subsequent examination on the subject shows a transfer deficit that has not been reported in this way in previous studies on this topic, which shows a general lack of randomized studies in this field. In the future, a more careful consideration is needed regarding the situations in which simulator training can be useful and in which training in a more clinical setting remains necessary.

Publication History

Article published online:
13 February 2024