“…Several TEE simulators have been tested in the past few years, such as a web-based training system or a mannequin-and computer-assembled simulation training module [15]. In comparing with traditional TEE training, both web simulator based TEE training and mannequin based TEE training module greatly simplify the understanding of TEE anatomy, image orientation and significantly reduce the learning time and curve [6,16]. There are few disadvantages of these simulators, for example, using web based TEE simulator, trainees is not allowed to have onsite practice in actual probe manipulations and image acquisition, while mannequin based TEE training module is very expensive and such high cost prohibit its widespread use.…”