The aim of this systematic review was to determine whether ultrasound (US)/US procedural simulation leads to improvement in US competence, particularly in the clinical setting. The electronic databases MEDLINE, EMBASE, CINAHL, ERIC, and OVID were searched for relevant published articles between 1950 and April 2011. Fourteen articles of an initial 371 articles met the inclusion criteria. The eligible studies differed in terms of the study population, sample size, study design, US simulator used, and measured outcomes. Most of the studies demonstrated acquisition of knowledge and skills with suggestions of correlation with simulation training and improved performance in the same simulated environment. There is little compelling evidence based on published studies at present to support the widespread adoption of simulation-based medical education to improve clinical US competence.

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This study examines the common carotid intimalmedial wall thickness (CCA-IMT) in untreated patients with elevated clinic blood pressure (BP) but normal ambulatory BP (isolated clinic hypertension, n ‫؍‬ 22), in comparison with a group with elevated clinic and ambulatory BP (hypertensives, n ‫؍‬ 41) and a group with normal clinic and ambulatory BP (normotensives, n ‫؍‬ 17) readings. The three groups did not differ in age, male/female ratio, lipid profile, glucose tolerance test, or smoking habits.No difference existed in CCA-IMT values between the groups with hypertension (0.67 ؎ 0.18 mm) and isolated clinic hypertension (0.68 ؎ 0.14 mm), but the values in these two groups were significantly higher (one-way ANOVA; F ‫؍‬ 8.09, P < .001) than in the group of normotensives (0.50 ؎ 0.09 mm). The CCA-IMT did not correlate with clinic systolic or diastolic BP readings or with BP derivatives of 24-h ambulatory monitoring. Mean 24-h BP in the isolated clinic hypertensives did not differ from that in the normotensives, whereas both were lower than in the hypertensives.We conclude that changes in the CCA-IMT occuring in subjects with isolated clinic hypertension are equal to the changes in sustained hypertension, indicating that isolated clinic hypertension may not be a benign condition. Am J Hypertens 1999;12:245-250