Effects of simulation-based practice on focused assessment with sonography for trauma (FAST) window identification, acquisition, and diagnosis

Abstract

We compared the effects of simulator-based virtual ultrasound scanning practice with classroom-based ultrasound scanning practice on participants' knowledge of focused assessment with sonography for trauma (FAST) window quadrants and interpretation, and on participants' performance on live patient FAST examinations. Novices with little or no ultrasound training experience received simulation-based practice (n = 24) or classroom-based practice (n = 24). Participants who received simulation-based practice scored significantly higher on interpreting static images of FAST windows. On live patient examinations where participants scanned the right upper quadrant (RUQ), left upper quadrant (LUQ), and suprapubic quadrant of a normal patient and an ascites-positive patient, the classroom-based practice condition had a shorter scan time for the LUQ and a higher number of participants attaining high-quality window on the RUQ (normal patient only) and suprapubic quadrant (positive patient only) and correct window interpretation on the LUQ (normal patient only). Overall, classroom-based practice appeared to promote physical acquisition skills and simulator-based practice appeared to promote window interpretation skills. Accurate window interpretation is critical to identification of blunt abdominal trauma injuries. The simulator used (SonoSimulator) appears promising as a training tool to increase probe time and to increase exposure to FAST windows reflecting various anatomy and disease states.