Abstract: Objective To assess the impact of transthoracic echocardiography（TTE） skills training in Transesophageal endocardiography（TEE）trainees; Methods In this prospective randomized study, 84 anesthesiologists (novice in echocardiography) were randomized to either TTE+TEE group (n=41) or TEE group(n=43). A standardized pretest was administered before the training. The trainees in TTE+TEE group firstly learned TTE skills followed by simulation-based TEE training. And the trainees in TEE group only had simulation-based TEE training session. Comprehension in both groups was then assessed using a written posttest immediately after training and 4 weeks later; Results Pretest scores revealed similar knowledge among the trainees. The TTE group scored higher on echocardiography anatomy after the training session (71.5%±18.3% vs 48.8%±18.3%，p＜0.01；TTE+TEE group versus TEE group, respectively)，but scored lower in clinical applications(38.4%±8.7% vs 45.2%±14.2%，p＜0.01). The two groups showed no difference in patient safety，probe manipulation and pathology scores. In 4-weeks later test, TTE+TEE group scored higher on both view identification and structure identification questions. Conclusion This prospective randomized study demonstrated that，after TTE training, the trainees could know better in echocardiography anatomy，and the memory of TEE views and structures lasted longer.

Key words: Transthoracic Echocardiography, Transesophageal Echocardiography, Simulation, Anesthesiology