Effects of simulation for gynaecological ultrasound scan training: a systematic review.

Introduction: Simulation is a potentially promising solution to some of the challenges in delivering ultrasound training, and in the last decade, research in simulation-based education has rapidly expanded. There have been no prior focused systematic reviews on the effects of simulation on gynaecological ultrasound scan training. The aim of this review was to summarise and critically appraise the available evidence. Methods: Medline, EMBASE, CINHAL, BNI, PubMed, ERIC, Cochrane Library and ISRCTN Register of Clinical Trials were searched using selected terminology. No language restrictions were applied. The selection criteria were studies of all types that investigated the use of a simulator to teach gynaecological ultrasound. Data evaluating study outcomes, along with methodological details, were extracted in duplicate. The outcomes were classified according to the Kirkpatrick hierarchy and included: patient-related outcomes, such as discomfort; organisational efficiency outcomes, such as examination times; and trainee-related outcomes, such as competence, skill and confidence. Results: Fourteen studies with 573 participants were included: seven randomised controlled trials, three controlled observational studies and four uncontrolled observational studies. The use of simulation practice in gynaecological ultrasound in addition to standard approaches for teaching is associated with significant improvements in competence, skill and confidence of trainees and reduced patient discomfort, increased perceived patient safety and enhanced confidence in the trainee. Conclusion: Our findings suggest that simulation in the early stages of training in gynaecological ultrasound is beneficial for the trainee, patients and has organisational benefits through reduced examinations times and need for supervision. Future research needs to confirm these findings in the different settings.