Effectiveness of Simulation-Based Training on Transesophageal Echocardiography Learning : The SIMULATOR Randomized Clinical Trial
Importance: Evidence is scarce on the effectiveness of simulation-based training in transesophageal echocardiography (TEE).
Objective: To assess the effectiveness of simulation-based teaching vs traditional teaching of TEE knowledge and skills of cardiology fellows.
Design, Setting, and Participants: Between November 2020 and November 2021, all consecutive cardiology fellows inexperienced in TEE from 42 French university centers were randomized (1:1; n = 324) into 2 groups with or without simulation support.
Main Outcomes and Measures: The co-primary outcomes were the scores in the final theoretical and practical tests 3 months after the training. TEE duration and the fellows' self-assessment of their proficiency were also assessed.
Results: While the theoretical and practical test scores were similar between the 2 groups (324 participants; 62.6% male; mean age, 26.4 years) before the training (33.0 [SD, 16.3] points vs 32.5 [SD, 18.5] points; P = .80 and 44.2 [SD, 25.5] points vs 46.1 [SD, 26.1] points; P = .51, respectively), the fellows in the simulation group (n = 162; 50%) displayed higher theoretical test and practical test scores after the training than those in the traditional group (n = 162; 50%) (47.2% [SD, 15.6%] vs 38.3% [SD, 19.8%]; P < .001 and 74.5% [SD, 17.7%] vs 59.0% [SD, 25.1%]; P < .001, respectively). Subgroup analyses showed that the effectiveness of the simulation training was even greater when performed at the beginning of the fellowship (ie, 2 years or less of training) (theoretical test: an increase of 11.9 points; 95% CI, 7.2-16.7 vs an increase of 4.25 points; 95% CI, -1.05 to 9.5; P = .03; practical test: an increase of 24.9 points; 95% CI, 18.5-31.0 vs an increase of 10.1 points; 95% CI, 3.9-16.0; P < .001). After the training, the duration to perform a complete TEE was significantly lower in the simulation group than in the traditional group ( 8.3 [SD, 1.4] minutes vs 9.4 [SD, 1.2] minutes; P < .001, respectively). Additionally, fellows in the simulation group felt more ready and more confident about performing a TEE alone after the training (mean score, 3.0; 95% CI, 2.9-3.2 vs mean score, 1.7; 95% CI, 1.4-1.9; P < .001 and mean score, 3.3; 95% CI, 3.1-3.5 vs mean score, 2.4; 95% CI, 2.1-2.6; P < .001, respectively).
Conclusions and Relevance: Simulation-based teaching of TEE showed a significant improvement in the knowledge, skills, and self-assessment of proficiency of cardiology fellows, as well as a reduction in the amount of time needed to complete the examination. These results should encourage further investigation of clinical performance and patient benefits of TEE simulation training.
| Errataetall: |
CommentIn: JAMA Cardiol. 2023 Mar 1;8(3):256-257. - PMID 36630126 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
JAMA cardiology - 8(2023), 3 vom: 01. März, Seite 248-256 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pezel, Théo [VerfasserIn] |
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| Anmerkungen: |
Date Completed 19.04.2023 Date Revised 10.05.2023 published: Print ClinicalTrials.gov: NCT05564507 CommentIn: JAMA Cardiol. 2023 Mar 1;8(3):256-257. - PMID 36630126 Citation Status MEDLINE |
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| doi: |
10.1001/jamacardio.2022.5016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355744112 |
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| 100 | 1 | |a Pezel, Théo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effectiveness of Simulation-Based Training on Transesophageal Echocardiography Learning |b The SIMULATOR Randomized Clinical Trial |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 19.04.2023 | ||
| 500 | |a Date Revised 10.05.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT05564507 | ||
| 500 | |a CommentIn: JAMA Cardiol. 2023 Mar 1;8(3):256-257. - PMID 36630126 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Importance: Evidence is scarce on the effectiveness of simulation-based training in transesophageal echocardiography (TEE) | ||
| 520 | |a Objective: To assess the effectiveness of simulation-based teaching vs traditional teaching of TEE knowledge and skills of cardiology fellows | ||
| 520 | |a Design, Setting, and Participants: Between November 2020 and November 2021, all consecutive cardiology fellows inexperienced in TEE from 42 French university centers were randomized (1:1; n = 324) into 2 groups with or without simulation support | ||
| 520 | |a Main Outcomes and Measures: The co-primary outcomes were the scores in the final theoretical and practical tests 3 months after the training. TEE duration and the fellows' self-assessment of their proficiency were also assessed | ||
| 520 | |a Results: While the theoretical and practical test scores were similar between the 2 groups (324 participants; 62.6% male; mean age, 26.4 years) before the training (33.0 [SD, 16.3] points vs 32.5 [SD, 18.5] points; P = .80 and 44.2 [SD, 25.5] points vs 46.1 [SD, 26.1] points; P = .51, respectively), the fellows in the simulation group (n = 162; 50%) displayed higher theoretical test and practical test scores after the training than those in the traditional group (n = 162; 50%) (47.2% [SD, 15.6%] vs 38.3% [SD, 19.8%]; P < .001 and 74.5% [SD, 17.7%] vs 59.0% [SD, 25.1%]; P < .001, respectively). Subgroup analyses showed that the effectiveness of the simulation training was even greater when performed at the beginning of the fellowship (ie, 2 years or less of training) (theoretical test: an increase of 11.9 points; 95% CI, 7.2-16.7 vs an increase of 4.25 points; 95% CI, -1.05 to 9.5; P = .03; practical test: an increase of 24.9 points; 95% CI, 18.5-31.0 vs an increase of 10.1 points; 95% CI, 3.9-16.0; P < .001). After the training, the duration to perform a complete TEE was significantly lower in the simulation group than in the traditional group ( 8.3 [SD, 1.4] minutes vs 9.4 [SD, 1.2] minutes; P < .001, respectively). Additionally, fellows in the simulation group felt more ready and more confident about performing a TEE alone after the training (mean score, 3.0; 95% CI, 2.9-3.2 vs mean score, 1.7; 95% CI, 1.4-1.9; P < .001 and mean score, 3.3; 95% CI, 3.1-3.5 vs mean score, 2.4; 95% CI, 2.1-2.6; P < .001, respectively) | ||
| 520 | |a Conclusions and Relevance: Simulation-based teaching of TEE showed a significant improvement in the knowledge, skills, and self-assessment of proficiency of cardiology fellows, as well as a reduction in the amount of time needed to complete the examination. These results should encourage further investigation of clinical performance and patient benefits of TEE simulation training | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Dreyfus, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Mouhat, Basile |e verfasserin |4 aut | |
| 700 | 1 | |a Thébaut, Clémence |e verfasserin |4 aut | |
| 700 | 1 | |a Audureau, Etienne |e verfasserin |4 aut | |
| 700 | 1 | |a Bernard, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Badie, Yoan Lavie |e verfasserin |4 aut | |
| 700 | 1 | |a Bohbot, Yohann |e verfasserin |4 aut | |
| 700 | 1 | |a Fard, Damien |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Lee S |e verfasserin |4 aut | |
| 700 | 1 | |a Monteil, Cécile |e verfasserin |4 aut | |
| 700 | 1 | |a Bière, Loïc |e verfasserin |4 aut | |
| 700 | 1 | |a Le Ven, Florent |e verfasserin |4 aut | |
| 700 | 1 | |a Canu, Marjorie |e verfasserin |4 aut | |
| 700 | 1 | |a Ribeyrolles, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Mion, Baptiste |e verfasserin |4 aut | |
| 700 | 1 | |a Bazire, Baptiste |e verfasserin |4 aut | |
| 700 | 1 | |a Fauvel, Charles |e verfasserin |4 aut | |
| 700 | 1 | |a Cautela, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Cambet, Théo |e verfasserin |4 aut | |
| 700 | 1 | |a Le Tourneau, Thierry |e verfasserin |4 aut | |
| 700 | 1 | |a Donal, Erwan |e verfasserin |4 aut | |
| 700 | 1 | |a Lafitte, Stéphane |e verfasserin |4 aut | |
| 700 | 1 | |a Magne, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Mansencal, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Coisne, Augustin |e verfasserin |4 aut | |
| 700 | 0 | |a SIMULATOR investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Aghezzaf, Samy |e investigator |4 oth | |
| 700 | 1 | |a Blanchard, Virginie |e investigator |4 oth | |
| 700 | 1 | |a Meilhac, Alexandra |e investigator |4 oth | |
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