Focused cardiac ultrasound training in medical students: Using an independent, simulator‐based curriculum to objectively measure skill acquisition and learning curve

Abstract

Background Using simulators built and validated at the University of Washington (UW), the study sought to test whether medical students can learn the basic skills of focused cardiac ultrasound (FoCUS) from an individually paced, simulator‐based curriculum, how skills improve, and the rate at which these skills are acquired. Methods The curriculum presented didactic material interspersed with hands‐on practice. Psychomotor skill was measured by the angle error of the acquired image view plane relative to the correct image view plane. The rate of learning was assessed at baseline, after 7 practice cases, and after 10 cases. To assess the rate of learning, the same case was repeatedly presented at all three tests. To assess students’ ability to apply their learning, a previously unseen post‐test was included. Results A total of 41 students completed the course. Average angle error improved from 43° ± 24 pretraining to 23° ± 16 post‐training, with most students falling within one SD of the view angle acquired by sonographers. Regarding learning curve, or the rate of skill acquisition, an angle error of 43 ± 24° (pre) changed to 22 ± 14° (interim test, P < .0001 vs. pretest) and remained at that level for the post‐test evaluation on both the repeated case (23 ± 16°) and the new case (26 ± 18°). Conclusions This study describes the learning curve and technical skill acquisition in FoCUS. A simulator‐based curriculum improved medical student's skills in an objective and quantifiable manner. The individually paced curriculum allowed for independent knowledge and skill attainment, without facilitator oversight.

Use of Hand‐motion Analysis to Assess Competence and Skill Decay for Cardiac and Lung Point‐of‐care Ultrasound

“…Previous work has also shown that novices with no POCUS experience can rapidly learn POCUS image acquisition skills for both lung and cardiac POCUS. 23,24 These findings support the continued development of programs to train prehospital providers in POCUS when early diagnosis can have a major impact on patient outcomes. 11 Few novices reached the HMA metrics obtained by POCUS experts, despite the fact that most were deemed competent in image acquisition with the OSCE.…”

Ensino da ultrassonografia point-of-care na graduação médica

“…O que se sabe é que um currículo baseado em simulador melhora as habilidades do estudante de medicina de forma objetiva e quantificável. 28 Apesar das diferentes formas de ensino, a integração da disciplina de US no currículo gera feedbacks positivos por parte dos acadêmicos. Houve um estudo em que a totalidade dos participantes concordava ou concordava fortemente em adquirir certificação formal em US do trauma após a conclusão do curso.…”

Transesophageal echocardiography simulation: A review of current technology

“…A recent Denmark national needs assessment study for prioritizing procedures for a stimulation‐based cardiology curriculum showed that TEE came in second only to advanced life support 18,19 . Many recent studies have demonstrated the effectiveness of simulator‐based training for improving the ability of novice operators to achieve proficiency in echocardiography 20–26 …”