Education Research: Simulator-Based Training in Transcranial Doppler Ultrasound

Background and Objectives: Transcranial Doppler (TCD) ultrasound is recommended for measuring cerebral blood flow velocity to guide therapeutic intervention in patients with cerebrovascular diseases. However, the widespread use of TCD is hampered by a shortage of trained practitioners. This study evaluated the efficacy of a simulator-based curriculum in teaching novices the foundational skill to perform TCD insonation. Methods: We developed a curriculum on a novel simulator that incorporates interactive practice with real-time feedback. We assessed change in the skill levels of medical and premedical students without previous exposure to TCD from pretraining and posttraining tests. Psychomotor skill was assessed based on accuracy in insonating the middle cerebral, anterior cerebral, ophthalmic, basilar, and vertebral arteries. Cognitive skill (knowledge) was assessed using multiple-choice questions (MCQs). Results: < 0.0001, Cohen d = 2.5). The course, including pre-test and posttests, was completed in 2.6 ± 1.0 hours. Discussion: Simulator-based training rapidly improved the ability of novices to locate intracranial arteries for measurement of blood flow velocity. The data support the employment of simulator-based training as a foundational step to help alleviate the shortage of trained providers. The simulator's self-directed practice allows for scalable, standardized training.