Controlled Prospective Study on Ultrasound Simulation Training in Fetal Echocardiography: FESIM II

Abstract Purpose: To analyze the learning curves of ultrasound novices in fetal echocardiography during structured simulation-based ultrasound training (SIM-UT) including a virtual, randomly moving fetus. Methods: 11 medical students with minimal (<10h) prior obstetric ultrasound experience underwent 12 hours of structured fetal echo SIM-UT in individual hands-on sessions during a 6-week training program. Their learning progress was assessed with standardized tests after 2, 4, and 6 weeks of SIM-UT. Participants were asked to obtain 11 fetal echo standard planes (in accordance with ISUOG and AHA guidelines) as quickly as possible. All tests were carried out under real life examination-like conditions on a healthy, randomly moving fetus. Subsequently, we analyzed the rate of correctly obtained images and the total time to completion (TTC). As reference groups, 10 Ob/Gyn physicians (median of 750 previously performed Ob/Gyn scans) and 10 fetal echo experts (median of 15000 previously performed Ob/Gyn scans) were examined with the same standardized tests. Results: The students showed a consistent and steady improvement of their ultrasound performance during the training program. After 2 weeks, they were able to obtain >95% of the standard planes correctly. After 6 weeks, they were significantly faster than the physician group (p<0.001) and no longer significantly slower than the expert group (p=0.944). Conclusion: SIM-UT is highly effective to learn fetal echocardiography. Regarding the acquisition of the AHA/ISUOG fetal echo standard planes, the students were able to reach the same skill level as the expert group within six weeks.