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Simulator-based training for learning resuscitative transesophageal echocardiography

  • Jordan Chenkin (a1) (a2), Edgar Hockmann (a1) (a3) and Tomislav Jelic (a4)
Abstract
Objectives

Transesophageal echocardiography (TEE) is a relatively new resuscitation tool in the emergency department. Recent studies have demonstrated that it can impact diagnosis and management of critically ill patients. The objective of this study is to determine the effectiveness of a simulation-based curriculum for teaching emergency medicine residents a five-view TEE protocol.

Methods

Emergency medicine residents with previous ultrasound experience were invited to attend a 1-hour TEE training session. The training consisted of a didactic lecture followed by guided practice on a simulator. Performance was measured prior to training, after the training session, and by a transfer test 1 to 2 weeks after training. The primary outcome was the percentage of successful image generation using a scoring tool by two blinded reviewers.

Results

Twenty-two residents completed the study. The percentage of successful views increased from 44.5% (SD 27.9) at baseline to 98.6% (SD 3.5) after training (p < 0.001), and was 86.8% (SD 12.1) on transfer testing (p < 0.001).

Conclusion

A brief simulation-based teaching session was effective for teaching emergency medicine residents a five-view resuscitative TEE protocol. Future studies are needed to determine optimal methods for long-term skill retention.

Objectif

Le recours à l’échocardiographie transœsophagienne (ETO) dans les cas de réanimation est relativement nouveau au service des urgences. D'après des études récentes, les résultats de l'examen peuvent avoir une incidence sur le diagnostic et la prise en charge de maladies très graves. L’étude visait donc à déterminer l'efficacité d'une séance de formation par simulation sur un protocole d'ETO en cinq prises de vue à des résidents en médecine d'urgence (MU).

Méthode

Des résidents en MU ayant une expérience antérieure en échographie ont été invités à participer à une séance d'une heure sur l'ETO. Celle-ci se divisait en deux parties : enseignement magistral et application pratique guidée sur simulateur. Une mesure de la performance a été effectuée avant et après la séance de formation, puis de 1 à 2 semaines après celle-ci à l'aide d'un test d'application des connaissances. Le critère principal consistait dans le pourcentage de la production d'images réussies d'images et en leur évaluation par deux examinateurs tenus dans l'ignorance des faits, à l'aide d'une méthode de pointage.

Résultats

Au total, 22 résidents ont terminé l’étude. Le pourcentage de prises de vue réussies est passé de 44,5% (écart-type [σ] = 27,9) au départ à 98,6% (σ = 3,5) après la formation (p < 0,001), et celui-ci a atteint 86,8% (σ = 12,1) au test d'application des connaissances (p < 0,001).

Conclusion

La tenue d'une brève séance de formation par simulation s'est révélée efficace dans l'enseignement d'un protocole d'ETO en cinq prises de vue à des résidents en MU. Il faudrait toutefois mener d'autres études afin de déterminer les meilleures méthodes d'enseignement possible favorisant la mémorisation de la matière à long terme.

Copyright
Corresponding author
Correspondence to: Dr. Jordan Chenkin, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, AG245, Toronto, ON M4N 3M5; Email: Jordan.chenkin@utoronto.ca
References
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1.Olszynski, P, Kim, D, Chenkin, J, Rang, L. The core emergency ultrasound curriculum project: a report from the Curriculum Working Group of the CAEP Emergency Ultrasound Committee. CJEM 2018;20:176–82.
2.Arntfield, R, Pace, J, Hewak, M, Thompson, D. Focused transesophageal echocardiography by emergency physicians is feasible and clinically influential: observational results from a novel ultrasound program. J Emerg Med 2016;50:286–94.
3.Blaivas, M. Transesophageal echocardiography during cardiopulmonary arrest in the emergency department. Resuscitation 2008;78:135–40.
4.Arntfield, R, Pace, J, McLeod, S, et al. Focused transesophageal echocardiography for emergency physicians-description and results from simulation training of a structured four-view examination. Crit Ultrasound J 2015;7:27.
5.Ziesmann, MT, Park, J, Unger, BJ, et al. Validation of the quality of ultrasound imaging and competence (QUICk) score as an objective assessment tool for the FAST examination. J Trauma Acute Care Surg 2015;78:1008–13.
6.Fair, J, Mallin, M, Mallemat, H, et al. Transesophageal echocardiography: guidelines for point-of-care applications in cardiac arrest resuscitation. Ann Emerg Med 2018;71:201–7.
7.Sohmer, B, Hudson, C, Hudson, J, et al. Transesophageal echocardiography simulation is an effective tool in teaching psychomotor skills to novice echocardiographers. Can J Anaesth 2014;61:235–41.
8.Smelt, J, Corredor, C, Edsell, M, et al. Simulation-based learning of transesophageal echocardiography in cardiothoracic surgical trainees: a prospective, randomized study. J Thorac Cardiovasc Surg 2015;150:22–5.
9.Bloch, A, von Arx, R, Etter, R, et al. Impact of simulator-based training in focused transesophageal echocardiography: a randomized controlled trial. Anesth Analg 2017;125:1140–8.
10.Matyal, R, Mitchell, JD, Hess, PE, et al. Simulator-based transesophageal echocardiographic training with motion analysis: a curriculum-based approach. Anesthesiology 2014;121:389–99.
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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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