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Original Research: Critical Care |

Effectiveness of a Critical Care Ultrasonography Course

Yonatan Y. Greenstein, MD; Ross Littauer, MD; Mangala Narasimhan, DO, FCCP; Paul H. Mayo, MD, FCCP; Seth J. Koenig, MD, FCCP
Author and Funding Information

FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

aHofstra Northwell School of Medicine, New Hyde Park, NY

bYale School of Medicine, New Haven, CT

CORRESPONDENCE TO: Yonatan Y. Greenstein, MD, Hofstra Northwell School of Medicine, 410 Lakeville Rd, Ste 107, New Hyde Park, NY 11040


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2017;151(1):34-40. doi:10.1016/j.chest.2016.08.1465
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Background  Widespread use of critical care ultrasonography (CCUS) for the management of patients in the ICU 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, 3-day CCUS training program and evaluates its effectiveness.

Methods  Five consecutive CCUS courses, with a total of 363 people, were studied. The 3-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 completion of the courses. Hands-on image acquisition skills were tested at the completion of the course.

Results  Average scores on the pretest and posttest were 57% and 90%, respectively (P < .001). The average score on the hands-on test was 86%. Learners aged 20 to 39 years compared with learners ≥ 40 years old scored better on the pretest (64% vs 51%; P < 0.001), posttest (91% vs 88%; P < .010), and hands-on test (90% vs 82%; P < .001).

Conclusions  Learners demonstrated a significant improvement in written test scores that assessed cognitive and image interpretation abilities. In addition, 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 3-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).

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