Evaluating the effectiveness of high-fidelity simulation-based training on clinical skill transfer in obstetric ultrasound residents: a prospective randomized controlled trial

BACKGROUND: Traditional training in obstetric ultrasound is constrained by patient availability and ethical concerns. In contrast, simulation-based medical education offers a safe, repeatable, and realistic alternative by replicating clinical environments for hands-on practice. This study aims to evaluate the clinical transferability of skills acquired through simulation and compare its effectiveness with traditional training in improving residents’ ultrasound competencies. METHODS: This prospective randomized controlled study included 22 PGY-2 or PGY-3 residents recruited between 2020 and 2021. Participants were randomly assigned to either the simulator (n = 11) or traditional (n = 11) group. All participants underwent short-term mid-trimester fetal ultrasound training program consisting of 2 h of theoretical instruction and 5 h of hands-on skills training, using either a simulator or pregnant volunteers. Participants were required to complete mid-trimester ultrasound assessments on both the simulator and pregnant volunteers before and after training. Assessment scores were evaluated by ultrasound consultants using the validated Objective Ultrasound Competency Assessment Tool. RESULTS: After training, both groups showed significant improvement in post-test scores (p < 0.05). Trainees in the simulator group not only demonstrated enhanced assessment scores in the simulated environment (57.7 ± 11.0vs81.0 ± 5.6, p < 0.01) but also exhibited notable improvements in their skills in the real clinical setting (53.5 ± 8.8vs74.1 ± 12.0, p < 0.01). A comparison of the assessment scores between the two groups revealed that the type of training had a significant impact on the residents’ performance improvement, with simulator-based training proving to be more effective than traditional training (p < 0.05) and showing a large effect size (Partial η²>0.14). Pearson correlation analysis indicated a strong positive correlation between the scores of assessment on simulator and the scores of assessment on pregnant volunteers (r > 0.7). CONCLUSIONS: Simulation-Based Medical Education enhances residents’ performance in both simulated environments and real clinical settings and is more effective than traditional clinical training methods. Additionally, simulation can serve as a powerful complement to traditional training and a safe alternative to patient-based assessment methods involving pregnant women. TRIAL REGISTRATION: This trial was registered at the Chinese Clinical Trial Registry with registration number ChiCTR2500107408 on August 11, 2025 (Retrospectively registered).