OBJECTIVE: To assess the validity and reliability of performance measures, develop credible performance standards, and explore learning curves on a virtual reality simulator designed for transvaginal gynaecological ultrasound.

METHODS: A group of 16 ultrasound novices, along with a group of 12 OB/GYN consultants, were included in this experimental study. The first two performances of the two groups on seven selected modules on a high-fidelity ultrasound simulator were used to identify valid and reliable metrics. Performance standards were determined and novices were instructed to continue practicing until they attained the performance level of an expert subgroup (n = 4).

RESULTS: All participants (n = 28) completed the selected modules twice and all novices reached the expert performance level. Of 153 metrics, 48 significantly discriminated between the two groups' performances. The ultrasound novices scored a median of 43.8% (range 17.9 to 68.9), and the OB/GYN consultants scored a median of 82.8% (range 60.4 to 91.7) of the maximum sum score, p < 0.001. The ultrasound novices reached the expert level (88.4%) within a median of five iterations (range five to six) corresponding to an average of 3 hours and 39 minutes (range 150 to 251 minutes) of training. The test/re-test reliability was high, Intraclass Correlation Coefficient = 0.93.

CONCLUSION: Gynaecological ultrasound competence can be assessed in a valid and reliable way using virtual reality simulation. The novices' performances improved with practice and their learning curves plateaued at the level of expert performance, which corresponded to between three to four hours of simulator training.