Simulation-based learning of transesophageal echocardiography in cardiothoracic surgical trainees: A prospective, randomized study

Smelt, Jeremy; Corredor, Carlos; Edsell, Mark; Fletcher, Nick; Jahangiri, Marjan; Sharma, Vivek

doi:10.1016/j.jtcvs.2015.04.032

Cited by 24 publications

(39 citation statements)

References 18 publications

(23 reference statements)

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“…This is the first study comparing three different teaching methods for transesophageal echocardiography. Previous studies either evaluated the difference between simulation training and conventional didactic training and e-learning [9,10,12,13,18,19] and only two authors compared simulation training with hands-on training in the operating room, [3,14] which is considered as the “golden-standard” for teaching TEE. The majority of these studies revealed a superiority of simulation training compared with the other methods.…”

Section: Discussionmentioning

confidence: 99%

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Resident performance in basic perioperative transesophageal echocardiography

et al. 2019

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Background:Training in transesophageal echocardiography (TEE) is based on hands-on training in the operating room, which is time consuming and therefore limits its experience among anesthesiologists. Medical simulations have been successfully used for training of invasive procedures in many areas.This paper compares the difference in effectiveness of teaching the 11 basic TEE views using either e-learning, simulation based training or hands-on training in the operating room in 3 groups of residents.Methods:We included 51 anesthesia and intensive care residents of all training levels but no prior training in echocardiography in this prospective randomized single-center study.Residents received a tutorial about theoretical knowledge followed by 2 practical study sessions either by e-learning using an online simulator (www.pie.med.utoronto.ca/TEE), with the simulation mannequin (CAE Vimedix Simulator) or in the operating room. Both, a theoretical multiple choice test (0–50 points) and a practical exam test (0–110 points) on the simulation mannequin had to be completed.The primary endpoint was the post-training scores in the practical and theoretical exams after all training sessions.Results:Residents received significantly higher test scores in both practical and theoretical examinations after training with the simulation mannequin (108.41 ± 2.09, 40.6 ± 5.23, n = 17) compared with e-learning (106.88 ± 4.53, 36 ± 4.76, n = 17) or hands-on training (106.82 ± 2.01, 34.94 ± 4.72, n = 17).Conclusions:Simulation based TEE training provides more effective training than other teaching methods. It is therefore especially suitable for the initial stages of TEE training to acquire psychomotor skills and knowledge of echo-anatomy.

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Section: Discussionmentioning

confidence: 99%

“…It enhances not only patient safety and comfort but is also superior to conventional didactic training (e.g., self study, e-learning). [7–14] So far there are only 2 studies evaluating simulation based training versus hands-on training in the operation room, [3,14] and no study comparing all 3 teaching methods.…”

Section: Introductionmentioning

confidence: 99%

Resident performance in basic perioperative transesophageal echocardiography

et al. 2019

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“…This was a pilot educational intervention with the goal to improve cardiac ultrasound image interpretation skill by trainees, specifically, qualitative interpretation of LV systolic function. Many existing educational echocardiography tools that we have come across in our review of the literature focus on didactics related to facts about echocardiography, some of which may be about how to assess LV function, and have assessments that tested more basic knowledge of echocardiographic facts (6,12,13). This is different than a focus on developing and applying specifically the skill of image interpretation as we aimed to do here.…”

Section: Discussionmentioning

confidence: 99%

Tool to Improve Qualitative Assessment of Left Ventricular Systolic Function

et al. 2020

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Interactive online learning tools have revolutionized graduate medical education and can impart echocardiographic image interpretive skills. We created self-paced, interactive online training modules using a repository of echocardiography videos of normal and various degrees of abnormal left ventricles. In this study, we tested the feasibility of this learning tool. Thirteen anesthesia interns took a pre-test and then had 3 weeks to complete the training modules on their own time before taking a post-test. The average score on the post-test (74.6% ± 11.08%) was higher than the average score on the pre-test (57.7% ± 9.27%) (P < 0.001). Scores did not differ between extreme function (severe dysfunction or hyperdynamic function) and non-extreme function (normal function or mild or moderate dysfunction) questions on both the pre-test (P = 0.278) and post-test (P = 0.093). The interns scored higher on the post-test than the pre-test on both extreme (P = 0.0062) and non-extreme (P = 0.0083) questions. After using an online educational tool that allowed learning on their own time and pace, trainees improved their ability to correctly categorize left ventricular systolic function. Left ventricular systolic function is often a key echocardiographic question that can be difficult to master. The promising performance of this educational resource may lead to more time- and cost-effective methods for improving diagnostic accuracy among learners.

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“…Several studies highlighted the impact of simulator-based transesophageal echocardiography teaching versus operating-room teaching in anesthesia trainees. [ 7 8 ] Currently there is a lack of research focusing on TTE training.…”

Section: Introductionmentioning

confidence: 99%

Impact of simulator-based training on acquisition of transthoracic echocardiography skills in medical students

Hempel¹,

Turton

Hasheminejad

et al. 2020

Ann Card Anaesth

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Introduction: Due to the expanding role of ultrasound as a diagnostic tool in modern medicine, medical schools rapidly include ultrasound training in their curriculum. The objective of this study was to compare simulator-based training along with classical teaching, using human models, to impart focused transthoracic echocardiography examination. Subject and Methods: A total of 22 medical students, with no former transthoracic echocardiography training, undertook a 90-min e-learning module, dealing with focused echocardiography and important echocardiographic pathologies. Subsequently, they had to complete a multiple-choice-questioner, followed by a 120-min practical training session either on the Heartworks™, (Cardiff, UK) and the CAE Vimedix ® , (Québec, Canada) simulator ( n = 10) or on a live human model ( n = 12). Finally, both groups had to complete a post-test consisting of ten video-based multiple-choice-questions and a time-based, focused echocardiography examination on another human model. Two blinded expert observers scored each acquired loop which recorded 2 s of each standard view. Statistical analysis was performed with SPPS 24 (SPSS™ 24, IBM, USA) using the Mann-Whitney-Test to compare both groups. Results: Analysis of measurable outcome skills showed no significant difference between transthoracic echocardiography training on human models and high-fidelity simulators for undergraduate medical students. Conclusions: Both teaching methods are effective and lead to the intended level of knowledge and skills.

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Simulation-based learning of transesophageal echocardiography in cardiothoracic surgical trainees: A prospective, randomized study

Cited by 24 publications

References 18 publications

Resident performance in basic perioperative transesophageal echocardiography

Resident performance in basic perioperative transesophageal echocardiography

Tool to Improve Qualitative Assessment of Left Ventricular Systolic Function

Impact of simulator-based training on acquisition of transthoracic echocardiography skills in medical students

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