SESSION TITLE: Education and Simulation
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: Widespread use of critical care ultrasound (CCUS) for the management of patients in the intensive care unit requires an effective training program. Experiential training and mentoring, while effective, is not a practical method to train a large number of intensivists, especially in centers that lack expert level intensivist ultrasonographers. National and regional CCUS training programs have been developed to meet this need, though their effectiveness is not yet known. This study describes a national level, simulation-based, three day CCUS training program and evaluates its effectiveness.
METHODS: The three day CCUS training program consisted of didactic lectures, ultrasound interpretation sessions, and hands-on modules with live models. Thoracic, vascular, and abdominal ultrasonography were taught in addition to goal-directed echocardiography. Learners were divided into two groups that rotated between hands-on training and interpretation sessions. The teacher to learner ratio was 1:3 during hands-on training. Interpretation sessions were composed of interactive small groups that reviewed normal and abnormal ultrasound images concordant with the objectives of the hands-on training. Two consecutive CCUS courses, which enrolled a total of 209 people, were studied. Learners completed a video-based examination before and after the courses completion. Hands-on skills were tested at the completion of the course.
RESULTS: Average scores on the pre and post-test were 11/20 (55%) and 18/20 (90%), respectively [p = 2.5 x 10-47]. The average score on the hands-on test was 18/20 (90%, range 15%-100%). Learners ages 20-39 compared to learners > 40 years old scored better on the pre-test (65% vs. 50%, p = 1.1 x 10-7) and hands-on test (90% vs. 85%, p = 1.2 x 10-4). Both age groups achieved similar scores on the post-test. Learners with prior experience using ultrasonography for vascular access scored higher on all tests compared to those without such prior experience.
CONCLUSIONS: Learners demonstrated a significant improvement in written test scores which assessed cognitive and image interpretation abilities. Additionally, they demonstrated acquisition of practical skills as evidenced by high scores during hands-on testing. Further studies are needed to determine if a simulation-based CCUS course will translate into effective clinical practice.
CLINICAL IMPLICATIONS: This three day course is an effective method to train large groups of intensivists in the skills requisite for CCUS: image acquisition and image interpretation.
DISCLOSURE: Yonatan Greenstein: Other: I have received an honorarium for teaching at the ACCP course which is described in this abstract. Mangala Narasimhan: Other: I have received an honorarium for teaching at the ACCP course which is described in this abstract. Paul Mayo: Other: I have received an honorarium for teaching at the ACCP course which is described in this abstract. Seth Koenig: Other: I have received an honorarium for teaching at the ACCP course which is described in this abstract. The following authors have nothing to disclose: Ross Littauer
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