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Simulation of Congenital Heart Defects - A Novel Way of Training Echocardiography
  1. Michael Weidenbach (michael.weidenbach{at}
  1. Heart Centre Leipzig, Germany
    1. Vit Rázek
    1. Heart Centre Leipzig, Germany
      1. Florentine Wild
      1. Heart Centre Leipzig, Germany
        1. Sachin Khambadkone (khambs{at}
        1. Great Ormond Street Hospital for Children, United Kingdom
          1. Thomas Berlage
          1. Fraunhofer Institute for Applied Information Technology, Germany
            1. Jan Janoušek
            1. Heart Centre Leipzig, Germany
              1. Jan Marek
              1. Great Ormond Street Hospital for Children, United Kingdom


                Objectives: Designing and validating a simulator for training in paediatric echocardiography.

                Background: Echocardiography is one of the most important diagnostic imaging modalities in paediatric cardiology. Due to the large number of lesions, achieving expertise often requires years of training. Echocardiography is still taught using the apprenticeship model, which is time- and personnel consuming. Therefore we have extended our simulator EchoCom to enable simulation of congenital heart lesions.

                Methods: The simulator consists of a life-size manikin, a dummy transducer with attached 3D tracking system and a computer application. Transthoracic Real-time (RT) three-dimensional (3D) data were collected and embedded into the simulator. Two-dimensional images are calculated and re-sliced from these data sets according to the position of the tracking sensor. Ten RT3D data sets of congenital heart lesions were selected for validation. For each data set a list of relevant findings that should be identified were determined. Data sets were blinded and without additional information presented to 43 participants who were stratified according to their expertise (12 experts, 16 intermediates and 15 beginners). Participants were asked to list the relevant findings and make a diagnosis. Construct validation was tested comparing diagnostic performance for each group. Face and content validation were tested using a standardised questionnaire.

                Results: Participants judged the simulator as realistic and useful. Main drawback was the adult size of the manikin. Diagnostic performance of each group differed significantly proving construct validity.

                Conclusions: According to our validation our prototype simulator could make a significant contribution for training paediatric echocardiography.

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