1. What data in particular will be shared?
   Response - All of the individual participant data collected during the trial, after de-identification.
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   Response - Informed Consent Form
   
   
3. Who will be able to view these files?
   Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.
   


4. For what types of analyses will this data be available?
   Response - For individual participant data meta-analysis.
   


5. By what mechanism will data be made available?
   Response - Proposals should be directed to [drayeshagoyal@gmail.com].
   


6. For how long will this data be available start date provided 01-08-2022 and end date provided 31-07-2024?
   Response - Beginning 9 months and ending 36 months following article publication.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - NIL

Medical training depends on real life experience with actual patients to hone the skills of health professionals at some point during the training. At the same time, there is a moral & ethical duty to provide suitable treatment and to ensure patient’s safety and well-being. These conflicting needs create a fundamental ethical tension in medical education, one that is widely recognized although little discussed. Medical training using simulation can prove to be a valuable tool in mitigating these ethical tensions and practical dilemmas.

The concept of simulation as an educational tool in healthcare is not a new idea but its use has really blossomed over the last few years. This enthusiasm is partly driven by an attempt to increase patient safety and patient care and also because the technology is becoming more affordable and advanced besides number of advantages it presents over more traditional methods of teaching and learning.¹Interest in simulation-based medical training has also increased due to challenges in medical education like increasingly limited availability of patients and instruction time, training in highly technical procedures, and the ethical issues raised by the patient safety movement.²

Anesthesiology is a hands-on specialty. As in other hands-on specialties such as surgery and emergency medicine, the only way to master a skill is to practice it again and again. Simulation provides a safe learning environment where anesthesiology residents and students can be taught, practice, and be evaluated on technical skills such as intubation and ventilation without ever putting a real patient at risk³. It is therefore not surprising that simulation has gained considerable interest and acceptance into anesthesiology education and curriculum. Anesthesiology is in fact the pioneer for the introduction of simulation into medical education⁴. Anesthesiology was instrumental in the development of a high fidelity human simulation used for medical education in other medical specialties as well.

These developments represent a turning point at which simulation is no longer seen as a novelty whose existence needs to be justified or defended by a few staunch believers.

Echocardiography is the commonest form of non-invasive cardiac imaging. However, being technically demanding, it is also operator dependent who are to be trained in a well defined pathway and require ongoing accreditation to achieve and maintain competency. However, to satisfy these requirements, significant time has to be dedicated to scanning patients, often in the time pressured clinical environment. Alternative, computer based simulated training methods are being considered to augment echocardiographic training and with considerable advancement in technology, development of interactive programs and simulators to train the clinicians has resulted in acquirement of skills to perform procedures. The more invasive specialties within the medical field including Anaesthesia also have exposure to simulation training, with simulators now available for teaching of bronchoscopy, transothoracic echocardiography (TTE) and transesophageal echocardiography (TEE).

Training in TTE requires mastery over both technical and cognitive skills which has been achieved traditionally through didactics, observations, and independently performed examinations. We propose to undertake this prospective randomized superiority study to evaluate the impact of simulation in teaching basic echocardiography principles and skills of image acquisition and anatomy recognition to residents compared to traditional teaching meth­ods like didactic lectures or hands-on exposure in TTE.