Impact of online transesophageal echocardiographic simulation on learning to navigate the 20 standard views

Abstract

Objective: To overcome a challenge in transesophageal echocardiographic (TEE) training, an online virtual TEE simulation was developed that allows the user to navigate among the 20 standard views. The TEE probe position and ultrasound plane movements on a 3-dimensional heart model were displayed with the corresponding TEE video recording as the probe was moved among the views.

Design: This study evaluated the educational benefit of the virtual TEE application using a pretest/post-test design.

Setting: Single academic teaching hospital.

Participants: Ten postgraduate physician volunteers who were novice echocardiographers.

Interventions: In a controlled environment, 10 study subjects completed a 20 multiple-choice question pretest, used the simulation for 1 hour, and then completed a 20 multiple-choice question post-test. Percentages of correct answers for each test were recorded for each subject.

Measurements and main results: The hypothesis that the median improvement in the number of questions correctly answered was different from 0 was tested with a related-samples Wilcoxon signed-rank test. A p value <0.05 was considered significant. A 1-hour exposure to the virtual TEE simulation produced a significant improvement (p = 0.005) in the post-test score (median 80%) compared with the pretest score (median 20%).

Conclusions: Using the virtual TEE simulation for 1 hour significantly improves the trainees' knowledge of navigation among the 20 standard TEE views. This application freely is available on the Internet and will be a useful adjunct to TEE training programs.