Effectiveness of simulation-based transthoracic echocardiography training on Cardiac Sonography Students’ Learning

Purpose: A primary challenge that cardiac sonography students experience during the echocardiography learning process is correlating the anatomical structures of the heart to transducer-created two-dimensional (2D) ultrasound images. Simulation-based training using a manikin may enhance learning, but evidence supporting its effectiveness in Transthoracic Echocardiography (TTE) education remains limited. This study evaluates the effectiveness of simulation-based versus traditional didactic teaching of cardiac anatomy and corresponding TTE images. Methods: A simulation-based learning lab was introduced in the fall of 2023 within the Cardiac Anatomy TTE course at our institution. Thirty-five first-year cardiac sonography students (with no prior TTE training) completed the traditional didactic course, including pre- and post-course assessments, and participated in a hands-on simulation lab. The session included real-time scanning of a manikin for Parasternal Long Axis, Parasternal Short Axis, Apical 4 Chamber, and Apical 2 Chamber views, alongside an interactive three-dimensional (3D) cardiac anatomy review. The outcomes were compared to a control group (spring 2023 students; n = 42) that completed the didactic course without simulation. Results: Post-course assessment scores were significantly higher in the simulation cohort ( p < 0.0001), with an increase in mean scores from 72.12% (control) to 88.23% (simulation). The knowledge gain was more consistent in the simulation group (SD 3.26%) compared to the control (SD 13.38%). The lowest score in the simulation cohort was 76.47%, compared to 41.18% in the control. Conclusion: Simulation-based teaching significantly enhances knowledge acquisition and retention in cardiac anatomy TTE training of cardiac sonography students. Our findings support integrating structured simulation into echocardiography education to improve the learning process.