• David Canty, Jennifer Barth, Yang Yang, Nathan Peters, Andrew Palmer, Alistair Royse, and Colin Royse.
• Director of Ultrasound Simulation and Senior Lecturer, Department of Surgery, University of Melbourne. Consultant Anaesthetist, Department of Anaesthesia and Perioperative Medicine, Monash Medical Centre, Department of Medicine, Monash University, Australia. Electronic address: dcanty@unimelb.edu.au.
• J Crit Care. 2019 Feb 1; 49: 38-44.

PurposeFocused cardiac ultrasound (FCU) training in critical care is restricted by availability of instructors. Supervised training may be substituted by self-directed learning with an ultrasound simulator guided by automated electronic learning, enabling scalability.Materials And MethodsWe prospectively compared learning outcomes in novice critical care physicians after completion of a supervised one-and-a-half-day workshop model with a self-guided course utilizing a simulator over four weeks. Both groups had identical pre-workshop on-line learning (20h). Image quality scores were compared using FCU performed on humans without pathology. Interpretive knowledge was compared using 20MCQ tests.ResultsOf 161 eligible, 145 participants consented. Total Image quality scores were higher in the Simulator group (95.2% vs. 66.0%, P < .001) and also higher for each view (all P < .001). Interpretive knowledge was not different before (78.6% vs. 79.0%) and after practical training (74.7% vs. 76.1%) and at 3 months (81.0% vs. 77.0%, all P > .1). Including purchase of the simulator and ultrasound equipment, the simulator course required lower direct costs (AUD$796 vs. $1724 per participant) and instructor time (0.5 vs.1.5 days) but similar participant time (2.8 vs. 3.0 days).ConclusionsSelf-directed learning with ultrasound simulators may be a scalable alternative to conventional supervised teaching with human models.Copyright © 2018 Elsevier Inc. All rights reserved.

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