# Comparative Efficacy of Simulation-Based and Traditional Training in Ultrasound-Assisted Regional Anesthesia for Medical Students: Randomized Controlled Trial

## TL;DR

This study compares simulation-based and traditional training for teaching ultrasound-guided regional anesthesia to medical students, finding both effective but with some differences in speed.

## Contribution

The study introduces a novel simulation-based training method for ultrasound-assisted regional anesthesia and evaluates its efficacy against traditional methods.

## Key findings

- No significant difference in success rates between simulation-based and traditional training for nerve identification.
- Traditional teaching was significantly faster for the sciatic nerve procedure.
- Both methods showed positive educational impacts despite no major differences in overall success.

## Abstract

Ultrasound is very important in medicine and teaching, but there are not many formal training programs. We also do not know much about what students think. To be good at using ultrasound, one needs to learn technical, thinking, and seeing skills. This is especially true in regional anesthesia (RA), where mistakes in reading images can cause problems. Training with simulations is a safe and good way to learn these skills. Some models are helpful for teaching how to perform procedures using ultrasound.

This study aimed to evaluate the effectiveness, localization time, and success rate of traditional teaching versus a new simulation-based teaching method for RA designed by the investigators among undergraduate medical students.

A prospective, randomized controlled trial was conducted at the University of Salamanca from April 2022 to January 2023. A total of 34 medical students in their fourth to sixth academic years were randomly allocated to either a simulation-based training group using the Haptic Ultrasound Probe or a traditional teaching group. The simulation approach used a realistic probe replica and a software-based ultrasound environment, whereas the traditional method comprised a theoretical lecture and curated audiovisual materials. Two days after training, participants underwent a blinded assessment requiring the identification of peripheral nerve plexuses using an ultrasound device. The primary outcome measured was the successful identification of nerves, and the secondary outcome was the time taken to complete each procedure. Data were analyzed using an intention-to-treat approach.

A total of 34 medical students (fourth to sixth years) were recruited to compare traditional teaching with simulation-based training in ultrasound-guided nerve localization. No statistically significant differences were found in the success rates between the groups. For the interscalene approach, the traditional teaching group achieved a 100% (17/17) success rate compared to 82% (14/17) in the simulation group (P=.07). The time to task completion was similar across most procedures. In the sciatic nerve division, the traditional teaching group was significantly faster, with a mean time of 42.4 (SD 39.5) seconds (P=.02). The regression models showed no significant interaction between the intervention type and academic year. Both teaching methods had positive educational impacts.

Simulation-based learning effectively supports competency acquisition in RA and offers a safe, scalable alternative to traditional methods. Its integration into medical curricula may standardize training, improve skill consistency, and enhance patient safety. Further multicenter studies with larger, diverse cohorts are needed to validate these benefits and guide implementation in medical education.