IMPROVING THE ULTRASOUND PATHOLOGY DETECTION RATE BY ADDING SIMULATOR TRAINING TO CONVENTIONAL ULTRASOUND EDUCATION

Purpose: Ultrasound education is complicated by locally different quantities and qualities of pathologic findings. Furthermore, ultrasound education is very time consumeing. Therefore we developed an ultrasound simulator and proved that it simulated the sonography of the abdomen reliably and reproducibly (Ultraschall in Med 2003; 24:239–244). However, a numerical improvement in sonographic skill following simulator training has not yet been shown.

Methods and Materials: During a conventional beginners and advanced level course of ultrasound of the abdomen, which were held according to DEGUM, ÖGUM and SGUM standards, half of the participants of the beginners course (n=22) and of the advanced level course (n=44) received as intervention group one hour of pathology detection training on the simulator. During this hour, the participants scanned 16 to 20 ultrasound cases of pathology relevant to their level of training on the simulator. The other half of the respective courses served as control group and received the standard course based ultrasound education, consisting in equal parts of lectures demonstrating ultrasound pathologies and scanning themselves as practical exercise. The sonographic skills were determined objectively and reproducibly at the beginning (B) and at the end (E) of the courses by scanning two different ultrasound simulator cases, each containing 3–5 different ultrasound pathologies.

Results: Training on the simulator improved the pathology detection rate from 16,9% (SEM 3,1%) to 25,7% (SEM 9,7%) in the beginners course, whereas it showed no significant change in the control group (B: 16,9% (SEM 3,1%); E: 10,5% (SEM 11,4%)).Both goups did not differ initially, whereas the increase of the pathology detection rate in the intervention group compared with the control group was significant in the paired, two-sided t-test (p=0,018). Furthermore, the pathology detection rate could also be improved significantly (p=0,0003) in the advanced level course by simulator training from 25,9% (SEM 10,5%) to 40,0% (SEM 11,0%).By contrast, the pathology detection rate did not change significantly in the control group (B: 28,0% (SEM 10,0%); E: 22,9% (SEM 20,3%)). The control and the intervention group did not differ initially, whereas the pathology detection rate was significantly higher in the intervention group following simulator education (p=0,008).

Conclusions: The current study shows for the first time that the hitherto course based ultrasound eduction does not improve the pathology detection rate and that baseline pathology detection rates are rather low in the advanced level courses. As the pathology detection rate was increased significantly by ultrasound simulator education as well in the beginners as in the advanced level courses, we recommend to include simulator education in the ultrasound education curriculum. Furthermore, the results of this study point out the essential necessity of continuous medical education and quality control in ultrasound, both of which can nicely be established with the ultrasound simulator.