The Effects of Simulation-based Transvaginal Ultrasound Training on Quality and Efficiency of Care: A Multicenter Single-blind Randomized Trial

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Abstract

Objective:

To explore the effect of adding simulation-based transvaginal ultrasound training to trainees’ clinical training compared with only clinical training on quality of and efficiency of care.

Background:

Simulation-based ultrasound training may be an effective adjunct to clinical training, but no studies have examined its effects on quality and efficiency of care.

Methods:

Trainees from 4 University Hospitals in East Denmark were included (N = 54). Participants were randomized to either simulation-based ultrasound training and clinical training (intervention group, n = 28), or to clinical training only (control group, n = 26).

Methods:

The primary outcome was patient-reported discomfort during transvaginal ultrasound examinations performed by study participants. Secondary outcomes included patient-reported perceived safety and confidence in ultrasound provider. Finally, the need for trainee supervision or repeated patient examinations was recorded.

Results:

In total, 1150 patient ratings were collected. The intervention was associated with a reduction of patient discomfort by 18.5% [95% confidence interval (CI), 10.7–25.5; P < 0.001), and with a 7.9% (95% CI, 0.5–14.7; P = 0.04) increase in perceived safety. The intervention group participants received 11.1% (95% CI, 2.5–18.9) higher scores on patients’ confidence compared with control group participants (P = 0.01). When the number of days of clinical training was doubled, the odds for trainee supervision or repeated patient examination was reduced by 45.3% (95% CI, 33.5–55.1) and 19.8% (95% CI, 4.1–32.9) in the intervention and control group, respectively (P = 0.005).

Conclusions:

Simulation-based ultrasound training improved quality of care and reduced the need for repeated patient examination and trainee supervision.

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