PURPOSE: We aimed to develop an introductory vascular and thoracic critical care ultrasonography (CCUS) workshop to improve intensivists’ knowledge and examination skills.
METHODS: The study was conducted in a tertiary care center. One week prior to the hands-on training session, 2-hour web-based didactic lectures were provided to the 16 intensivists (2 attending physicians and 14 fellows). The training in the simulation center included a 1-hour vascular examination on volunteer individuals and mannequins, a 1-hour thoracic examination on volunteer individuals, and a 30-minute interactive discussion with instructors. Pre- and post- workshop tests on knowledge and image interpretation were conducted on-line using 43 multiple-choice questions. Four scenario-based pre- and post-workshop skill tests (machine control, examination preparation, vascular examination, thoracic examination) were conducted and video-captured for evaluation by two blinded reviewers. The skill scores were calculated based on 28 pre-determined checklist items including intensivists’ responses and the adequacy of the ultrasound images obtained. A Bland-Altman plot was used to analyze agreement between two reviewers. Intensivists’ confidence levels on image acquisition were assessed by ten-point Likert scale. The performance measures before and after the workshop were evaluated using a paired t-test.
RESULTS: In knowledge tests, the mean (± SD) pre- and post-workshop scores were 24±4 and 33±5, respectively, p< 0.01. For the skill portion of the test, the mean (± SD) pre- and post-workshop scores were 15±5, and 23±2, respectively with p< 0.01. A Bland-Altman plot demonstrated that the scores by two reviewers were consistent and similar. Intensivists’ subjective confidence levels on image acquisition increased from 4±2 to 8±1, p< 0.01.
CONCLUSION: Web-based learning followed by hands-on training improves intensivists’ knowledge, image interpretation, machine control, and examination skills in vascular and thoracic CCUS along with their confidence levels on image acquisition.
CLINICAL IMPLICATIONS: This structured introductory CCUS workshop is a successful model course for busy intensivists. The lack of performance standards and the absence of long term follow up to assess the retention of knowledge and skills limit clinical implications at this time.
DISCLOSURE: Hiroshi Sekiguchi, No Financial Disclosure Information; No Product/Research Disclosure Information