Widespread use of critical care ultrasonography (CCUS) for the management of patients in the intensive care unit requires an effective training program. The effectiveness of national and regional CCUS training courses is not known. This study describes a national level, simulation-based, three day CCUS training program and evaluates its effectiveness.
Five consecutive CCUS courses, with a total of 363 people, were studied. The three day CCUS training program consisted of didactic lectures, ultrasonography interpretation sessions, and hands-on modules with live models. Thoracic, vascular, and abdominal ultrasonography were taught in addition to goal-directed echocardiography. Learners 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 ultrasonography images. Learners completed a video-based examination before and after the courses completion. Hands-on image acquisition skills were tested at the completion of the course.
Average scores on the pre and post-test were 57% and 90%, respectively (p < 0.001). The average score on the hands-on test was 86%. Learners ages 20-39 compared to learners ≥ 40 years old scored better on the pre-test (64% vs. 51%, p < 0.001), post-test (91% vs. 88%, p < 0.010), and hands-on test (90% vs. 82%, p < 0.001).
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 and to measure the durability of training.
This three day course is an effective method to train large groups of critical care clinicians in the skills requisite for CCUS: image acquisition and image interpretation.