Effectiveness of Simulation-based Training on Transoesophageal Echocardiography Learning

Background: Simulation-based training in transesophageal echocardiography (TEE) seems promising. However, data are limited to non-randomized or single-center studies. Objectives: This large multicenter randomized, parallel-group, unblinded, study will assess the impact of simulation-based versus traditional teaching on TEE knowledge and performance for medical fellows in cardiology. Eligibility: * All consecutive fellows in cardiology of all training levels (year 1-4) * who have never performed a TEE alone Design: * Multicenter, parallel-group, unblinded, randomized study with a prospective enrollment of all consecutive fellows in cardiology of all training level (year 1 to 4) who were recruited in 42 centers throughout France. * Randomization with stratification by center will be performed at the individual (fellow) level in 1:1 ratio to assign all the fellows to the traditional group or to the TEE simulation-based training group. * Each participant will complete two different tests during the study: 1) a pre-training test before starting the educational program; and 2) a final test performed 3 months after the end of the educational program. Each of these tests will include a theoretical test and a practical test on a TEE simulator. * The coprimary outcomes of the study to compare the two groups will be the scores in the final theoretical and practical tests after the training will be completed.