Education, Teaching, and Quality Improvement |

How Much Training Is Needed to Master Cardiac Echo? FREE TO VIEW

Courtney Bennett, DO
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Lehigh Valley Health Network, Emmaus, PA

Chest. 2015;148(4_MeetingAbstracts):456A. doi:10.1378/chest.2274237
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SESSION TITLE: Education & Simulation Poster Discussion

SESSION TYPE: Original Investigation Poster Discussion

PRESENTED ON: Sunday, October 25, 2015 at 04:30 PM - 05:30 PM

PURPOSE: Critical Care Specialists are increasingly expected to perform and apply bedside echocardiography in the care of their patients with cardiopulmonary distress, yet they receive little formal training in recognizing these images. Current classroom cardiac echo training is time-consuming, requiring months to achieve basic proficiency. We assessed the effect of intensive repetition (200 cardiac cycles) on cardiac echo skills in pulmonary, emergency and internal medicine physicians.

METHODS: A total of 68 volunteers (25 pulmonary fellows and attendings, 43 emergency and internal medicine physicians) took a pretest on 6 normal echocardiographic views (2 Subcostal, 2 Apical, and 2 Parasternal Views) presented in digital format as video clips. Participants were instructed to identify all 4 cardiac chambers, 2 valves and 4 ventricular walls. This pretest was followed by a 1 hour monitored training session of intensive repetition, using freeze frame to identify cardiac anatomy, slow motion to allow careful analysis of valve and wall motion and normal speed to permit integration of all the information. 200 cardiac cycles of each echo image were reviewed in each training session. A post-test comprised of different patients from the training images was used for the testing phase of the study.

RESULTS: Physicians’ correct answers improved from 49.5 +/- 16.9 % on the pretest to 89.0 +/- 9.8 % on the posttest, p<.001 by paired t-test. A post study survey of participants revealed a high degree of acceptance for this type of training and a desire for additional training on specific right heart pathologies which is currently in progress.

CONCLUSIONS: Intensive repetition training (200 cardiac cycles) of normal echocardiographic views can dramatically improve physicians’ proficiency in recognition of normal echo images in a short time frame.

CLINICAL IMPLICATIONS: As bedside echocardiography becomes a routine part of critical care specialists' skill set, it is important to find efficient methods to acquire this skill.

DISCLOSURE: The following authors have nothing to disclose: Courtney Bennett

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