# Efficiency of Using a Simulator for Ultrasound and Laser Dose Calculation in Physiotherapy
## 4 Discussion  
### Initial and Final Surveys Analysis  
When comparing the results recorded in the initial and final surveys concerning the contribution to the learning process of this new method compared to the traditional method, its efficiency and how helpful it is when solving calculation problems (Items 1, 2, and 5 respectively), it is observed that expected changes were higher than that experienced after discovering and using the simulator. Nevertheless, the results recorded concerning implementation of similar methods in other subjects, as well as spending a moderate amount of time to gain the necessary knowledge through this method (Items 3 and 4, respectively) confirm that students taking part in this study approve the use of this technique for learning purposes. The positive rating by the students to the communication process conducted by the teacher when describing how to solve dose calculation problems, as well as the use of the simulator, eliminate any potential bias arising from interferences in the process of conveying the necessary knowledge to participants. Even so, we must be careful when assessing the learning method used based on the results recorded in the surveys. As they have been completed online, they could be a little less reliable than if they had been completed face-to-face [8]. The results obtained in previous studies assumed the presence of students [7].  
### Initial and Final Surveys Analysis  
Although completing surveys on-line may seem a reliable method, using other methods for obtaining information and complementing that given on the surveys could strengthen the validity of the answers given by the surveyed persons [9]. This is the reason for why all the students participating in the study were subject to a written test. Through solving problems and recording the time necessary to complete the test, the test seeks to analyze whether there are differences among those using the simulator and those following the traditional method considering that they did not have any chance to contact the professor during their study. The results recorded in the test depict an equivalent or higher scoring and less time taken to solve the problems among those students practicing with the simulator before taking the test.  
Based on the results arising from this study, the concept that the online method is an efficient tool for learning purposes is shared by different authors [10; 11; 12] as far as new students are concerned [13]. For the sake of patient security, constraints do exist in real practice [5; 6], however these are offset by the repetition of practical cases revisited digitally, which allow practitioners to make an in-depth analysis on how to implement the treatment and obtain feedback [14; 15]. This could be also implemented by practitioners with the aim of facilitating their clinical daily job in situations going beyond the usual standards [16; 17], since this simulator supports scheduling a treatment within a wide range of parameters allowing its use in non-standardized contexts, unlike other digital simulation procedures [18].