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Ultrasound during Critical Care Simulation: A Randomized Crossover Study

  • Paul A. Olszynski (a1), Tim Harris (a2), Patrick Renihan (a3), Marcel D’Eon (a1) and Kalyani Premkumar (a1)...
Abstract
AbstractObjectives

We sought to compare two ultrasound simulation interventions used during critical care simulation. The primary outcome was trainee and instructor preference for either intervention. Secondary outcomes included the identification of strengths and weaknesses of each intervention as well as overall merits of ultrasound simulation during high-fidelity, critical care simulation. The populations of interest included emergency medicine trainees and physicians.

Methods

This was a randomized crossover study with two ultrasound simulation interventions. 25 trainees and eight emergency physician instructors participated in critical-care simulation sessions. Instructors were involved in session debriefing and feedback. Pre- and post-intervention responses were analyzed for statistically significant differences using t test analyses. Qualitative data underwent thematic analysis and triangulation.

Results

Both trainees and instructors deemed ultrasound simulation valuable by allowing trainees to demonstrate knowledge of indications, correct image interpretation, and clinical integration (p<0.05). Trainees described increased motivation to develop and use ultrasound skills. The edus2 was the preferred intervention, as it enabled functional fidelity and the integration of ultrasound into resuscitation choreography. Instructors preferred the edus2, as it facilitated better assessment of trainees’ skills, thus influencing feedback.

Conclusions

These findings support the use of ultrasound simulation during critical care simulations. The increased functional fidelity associated with edus2 suggests that it is the preferred intervention. Further study of the impact on clinical performance is warranted.

RésuméObjectifs

L’étude visait à comparer deux interventions échographiques simulées, dans le cadre de séances de formation en soins intensifs. Le principal critère d’évaluation consistait à déterminer la préférence des stagiaires et celle des instructeurs pour l’une ou l’autre des interventions. Les critères d’évaluation secondaires comprenaient les points forts et les points faibles de chacune des interventions ainsi que les avantages généraux de la simulation d’échographie dans le cadre de séances de formation réaliste en soins intensifs. La population concernée se composait de stagiaires en médecine d’urgence et d’urgentologues.

Méthode

Il s’agit d’une étude croisée, à répartition aléatoire, qui comptait deux interventions échographiques simulées. Vingt-cinq stagiaires et huit urgentologues instructeurs ont participé aux séances de simulation en soins intensifs. Les instructeurs étaient chargés des séances de compte rendu et de la rétroaction des stagiaires. Il y a eu analyse des réponses recueillies avant et après les interventions afin de dégager des écarts statistiquement significatifs à l’aide d’analyses fondées sur le test t. Quant aux données qualitatives, elles ont été soumises à une analyse thématique, puis à la triangulation.

Résultats

Tant les stagiaires que les instructeurs ont jugé intéressante la simulation d’échographie, les stagiaires ayant la possibilité de montrer leur connaissance des indications, d’interpréter correctement les images et d’intégrer la matière sur le plan clinique (p<0,05). Les stagiaires ont aussi fait état d’une motivation accrue pour acquérir des compétences en échographie et les appliquer. En outre, la deuxième intervention s’est révélée la formule préférée des stagiaires parce qu’elle avait un caractère fonctionnel réaliste et qu’elle permettait l’intégration de l’échographie dans l’enchaînement des gestes de réanimation. De leur côté, les instructeurs ont également indiqué leur préférence pour la deuxième intervention parce qu’elle facilitait l’évaluation des compétences des stagiaires et qu’elle influait, par le fait même, sur la rétroaction.

Conclusions

Les résultats de l’étude confirment la pertinence des simulations d’échographies dans le cadre de séances de formation en soins intensifs. C’est le caractère fonctionnel réaliste de la deuxième intervention qui en aurait fait la formule préférée. Il faudrait mener d’autres études afin de déterminer l’incidence de ce type d’enseignement sur la compétence clinique.

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Copyright
Corresponding author
Correspondence to: Dr. Paul Olszynski, Royal University Hospital, 103 Hospital Dr., Room 2686, Saskatoon, SK S7N 0W8; Email: p.olszynski@usask.ca
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Canadian Journal of Emergency Medicine
  • ISSN: -
  • EISSN: 1481-8035
  • URL: /core/journals/canadian-journal-of-emergency-medicine
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