Training Thoracic Ultrasound Skills: a Multicentre, Blinded, Randomized Controlled Trial of Simulation-based Training Versus Training on Healthy Figurants

Thoracic ultrasound (TUS) differs from ultrasound examinations in other organ systems, because it is not possible in the healthy, ventilated lung to visualize structures or anatomical parts of the lung, like it is when examining abdomen or performing an echocardiography. It is therefore not possible to transfer results directly from educational studies using simulation-based training in other areas of medicine, to thoracic ultrasound.

TUS examinations are considered safe, and without pain, exposure to radiation or delay of patients' course, but ultrasound in general is highly operator dependent and lack of theoretical knowledge or practical skills could potentially lead to incorrect diagnosis and thus treatment. Therefore simulation-based training, theoretical and practical tests could be the key to a "pre-trained novice" with a level of competency higher than a complete novice when performing the first TUS examination on a patient in a clinical setting.

The objective of this trial is to examine whether TUS training on a simulator is superior to training on healthy figurants, which today is a commonly used method for gaining skills and competencies in TUS. Secondly, to examine whether the choice of hands-on training has an effect on the number of examinations performed by the trainees from baseline to 3 months follow-up.

Methods The design is a three-armed, multicentre, blinded randomized controlled trial. The trial takes place at three simulation centres at university hospitals in Denmark; Odense University Hospital, Rigshospitalet, and Aarhus University Hospital. The intervention period is scheduled to run from August 2018 to May 2019.

Participants All physicians employed at public hospitals in Region of Southern Denmark, Capital Region of Denmark, Region Zealand, and Central Denmark Region, are eligible for inclusion in the trial. Because physicians from a wide range of specialities can benefit from TUS examinations, no exclusion criteria are established based on the specialities from the physicians.