Abstract Body (Do not enter title and authors here):
Introduction: Simulation-based training systems for Transesophageal Echocardiography (TEE) have been developed for medical education, but evidence on their effectiveness remains limited. This study aimed to evaluate the efficacy of simulation-based teaching compared to traditional methods in imparting TEE knowledge and skills to fellows.


Methods: A literature search was conducted across MEDLINE, Embase, and Cochrane databases. The primary endpoint was (1) post-intervention skill or knowledge assessment. A subgroup analysis was performed comparing anesthesiology and cardiology fellows. Additionally, a secondary single-arm analysis evaluated (2) the recommendation rate for simulation training among participants who underwent this form of tutoring. Statistical analysis was done using R Studio 4.3.2.

Results: We included 9 RCTs encompassing 602 fellows, of whom 293 (48.67%) underwent simulation training TEE with a mean age of 25. In the pooled analysis, the simulation group's post-test scores for TEE proficiency were significantly higher compared to the control group (SMD: 0.86; 95% [CI] 0.48-1.24; p < 0.01; Figure 1A). Our subgroup analysis showed no significant difference between anesthesiology and cardiology fellows (p=0.36; Figure 1B). The Likert recommendation score indicated a high recommendation rate of 92% (95% CI 0.75-1.00; Figure 2) for the simulation education group.

Conclusion: In this updated meta-analysis, fellows who underwent simulation training for TEE achieved higher post-assessment scores, and the Likert recommendation rate for simulation-based teaching was high. Additionally, there were no significant subgroup differences between the cardiology and anesthesiology fellows.