The Use of Ultrasound Simulators to Strengthen Scanning Skills in Medical Students: A Randomized Controlled Trial

Thomas Weiss, MD
Published April 6, 2022

Probetrotters | Medical Education

Study Design

This study was a randomized controlled trial using ultrasound simulators versus controls in medical students with prior point of care ultrasound training.


The primary objective of the study was to compare one group of medical students that used simulators and one group that did not to compare outcomes based on scanning skill and understanding of pathology.


Fourth year medical students (n=19) with prior POCUS experience were split into two groups, the first (n=10) did an undergraduate ultrasound training curriculum AND used a simulator to complete 2 self-directed practice ultrasound sessions. The second (n=9) only completed the undergraduate ultrasound training curriculum. Blind assessments before and after on standardized patients were performed and the students were evaluated based on their image acquisition. Additionally, there was a 22-point question assessment for pathology-based questions.

What are some possible flaws in the methods used?

Some possible flaws of the methods used could be that the grading system for image acquisition could be unequal among participants and those grading. Additionally, the images obtained from different standardized patients may have been more technically challenging than others. Finally, the medical students could have variable POCUS experience during medical school.


Image Acquisition exam: Study group 80.1%, control group 58.9% p =.003 (significant difference)

Questionnaire exam: Study group 77.7%, control group 57% p=.105 (non-significant difference)

Score difference statistically significant at p = .0007


POCUS simulators improve knowledge/skill for already learned skills, not new skills. It isn’t a replacement for live models, more as an adjunct. Larger sample sizes needed for generalization and further studies needed for long term effects of simulators on knowledge/skill retention.

Take Home Points

Ultrasound simulators can improve both POCUS knowledge and skill among medical students. Additionally, further studies are needed to determine the long term maintenance of skills and knowledge as this was only over a one month period.

Study Limitations

The main limitations of the study included a small sample size, limited evaluation of the medical students skill and knowledge, the inability to practice identifying pathology on the standardized patients, and that there were different evaluators for pre and post simulator training.

Does this study influence your practice?

While this won’t necessarily change my practice with patients, it shows the effect that simulators can have on medical education in general and how useful their incorporation into learning can be. This could be really important for medical student education for those interested in utilizing POCUS, especially emergency medicine physicians.