Evaluating the Effectiveness of High-Fidelity Simulation-Based Training on Clinical Skill Transfer in Obstetric Ultrasound Residents: A Prospective Randomized Controlled Trial

Background Traditional training in obstetric ultrasound is constrained by patient availability and ethical concerns. In contrast, simulation-based medical education offers a safe, repeatable, and realistic alternative by replicating clinical environments for hands-on practice. This study aims to evaluate the clinical transferability of skills acquired through simulation and compare its effectiveness with traditional training in improving residents’ ultrasound competencies. Methods This prospective randomized controlled study included 22 residents, randomly assigned to either the simulator (n = 11) or traditional (n = 11) group. All participants underwent short-term mid-trimester fetal ultrasound training, using either a simulator or real pregnant women. Participants were required to perform assessments on both the simulator and volunteer pregnant women before and after training. Assessment scores were evaluated by ultrasound consultants using Objective Ultrasound Competency Assessment Tool. Results After training, both groups showed significant improvement in post-test scores (p < 0.05). Trainees in the simulator group not only demonstrated enhanced assessment scores in the simulated environment(57.7 ± 11.0vs81.0 ± 5.6, p < 0.01) but also exhibited notable improvements in their skills in the real clinical setting(53.5 ± 8.8vs74.1 ± 12.0, p < 0.01). A comparison of the assessment scores between the two groups revealed that the type of training had a significant impact on the residents' performance improvement, with simulator-based training proving to be more effective than traditional training(p < 0.05) and showing a large effect size(Partial η²>0.14). Pearson correlation analysis indicated a strong correlation between the simulator assessment scores and the pregnant women assessment scores (r > 0.7). Conclusions Simulation-Based Medical Education enhances residents' performance in both simulated environments and real clinical settings and is more effective than traditional clinical training methods. Additionally, simulation can serve as a powerful complement to traditional training and a safe alternative to patient-based assessment methods involving pregnant women. Trial registration This trial was registered at the Chinese Clinical Trial Registry with registration number ChiCTR2500107408 on August 11, 2025 (Retrospectively registered).