# Competency of novice anesthesia residents in performing trans thoracic echocardiography following a structured problem-based hands-on course using a trans thoracic echocardiography simulator versus video-based training: a randomized controlled assessor-blinded trial

## TL;DR

A study found that hands-on simulator training improved anesthesia residents' echocardiography skills more than video-based training, though skills declined over time.

## Contribution

This study introduces a novel TTE Competency Score and compares hands-on simulation with video-based training for novice anesthesia residents.

## Key findings

- Simulation-based training led to higher immediate TTE Competency Scores compared to video-based training.
- Residents in the simulation group showed higher confidence levels six months post-training.
- Both groups experienced a decline in scores after six months, suggesting a need for refresher training.

## Abstract

Trans-thoracic echocardiography (TTE) improves the diagnostic skills of anesthesia trainees during the perioperative period. We compared performance between two educational intervention, simulation-based hands-on training and video-based training as measured by a novel TTE Competency Score (TCS).

Fifty novice anesthesia residents were randomized into an intervention group-I (received simulation-based training) and a control group-C (received video-based training). Both groups underwent evaluations of their knowledge and skills on live volunteers or ICU patients using TCS right after the training and again six months thereafter. An independent sample t-test was employed to compare TCS between the groups, while a paired t-test was used to assess intragroup TCS at the baseline, after training, and six months post-training.

The two groups had no significant difference in the pre-test assessment scores. Immediately following the training session, Group I exhibited a significantly higher TCS compared to Group C (25.2 ± 2.7 and 22.4 ± 2.5, p = 0.01). Compared to the I-group, the C-group made more attempts to achieve competence. Group I exhibited higher confidence levels both immediately and six months later. After a six-month follow-up, the TCS scores in both groups were lower than the scores recorded immediately.

This study demonstrates that a structured, problem-based simulator course improved immediate TCS and 6-month confidence compared with video-based training. However, a decline in TCS in both groups over time highlights the need for periodic refreshers within six months to improve retention.

CTRI [CTRI/2021/07/034684].

The online version contains supplementary material available at 10.1186/s41077-026-00406-1.