Simulation-based training in echocardiography

The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show inter...

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Published inEchocardiography (Mount Kisco, N.Y.) Vol. 33; no. 10; pp. 1581 - 1588
Main Authors Biswas, Monodeep, Patel, Rajendrakumar, German, Charles, Kharod, Anant, Mohamed, Ahmed, Dod, Harvinder S., Kapoor, Poonam Malhotra, Nanda, Navin C.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.10.2016
Subjects
Cardiology - education
Computer-Assisted Instruction - instrumentation
Computer-Assisted Instruction - methods
echocardiography
Echocardiography - instrumentation
Echocardiography - methods
echocardiography training
High Fidelity Simulation Training - methods
Manikins
Phantoms, Imaging
simulation
simulators
Software
Technology Assessment, Biomedical
transesophageal echocardiography
transthoracic echocardiography
transthoracic echocardiography
transesophageal echocardiography
echocardiography training
simulation
simulators
echocardiography
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Summary:The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show interest as well, including intensive care, anesthesia, and primary care trainees, in both transesophageal and transthoracic echocardiography. Advances in technology have led to the development of simulation programs accessible to trainees to help gain proficiency in the nuances of obtaining quality images, in a low stress, pressure free environment, often with a functioning ultrasound probe and mannequin that can mimic many of the pathologies seen in living patients. Although there are various training simulation programs each with their own benefits and drawbacks, it is clear that these programs are a powerful tool in educating the trainee and likely will lead to improved patient outcomes.
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Movie clips S1A-L. Simulation based two-dimensional transthoracic echocardiographic studies. (A-C) Parasternal long axis views. In the B-mode (B) and color Doppler (C), the oscillating structure moving to and fro between the left ventricle (LV) and left atrium (LA) may represent a mitral valve vegetation. (D, E) Parasternal short-axis views at the level of the papillary muscles. The bottom panel (in E) represents an M-mode tracing derived by passing a cursor line through the two-dimensional image (top panel). (F, G) Four chamber views. (H) Five-chamber view. (I) Five-chamber view demonstrating pericardial effusion (PE). (J) Ultrasound guided pericardiocentesis. The arrow points to a pericardiocentesis needle which is introduced into the PE space under ultrasound guidance taking care not to impinge or perforate the right ventricular (RV) wall. (K, L) Subcostal examination. The inferior vena cava (IVC) shows collapse. The corresponding M-mode tracing is shown in the bottom panel in L. AO = aorta; L = liver; RA = right atrium. Movie clips 1A, 1D-F, 1K and 1L are courtesy of HeartWorks, 1B,C, and G are courtesy of Simbionix, 1H is courtesy of EchoCom and 1I and 1J are courtesy of Blue Phantom, Advanced Medical Technologies.           Movie clips 2A-K. Simulation based two-dimensional transesophageal echocardiographic studies. A-C, represent four chamber views. (D) Five-chamber view showing color Doppler flow signals in the LV outflow tract. (E) Probe advancement to sequentially image four-chamber view, five-chamber view, LV short-axis view at the papillary muscle level and LV short axis view at the LV apex. (F) MV pulsed Doppler inflow signals. Both early (E) and late diastolic (A) waves are shown. (G, H) LV two-chamber view with transducer rotation to bring in the left atrial appendage (LAA) are shown. (I) Long-axis view. (J) The arrow points to an aortic valve vegetation prolapsing into the LV outflow tract. (K) Aortic regurgitation is shown by color Doppler flow signals (upper arrow) and by continuous-wave Doppler (lower arrow). MV = mitral valve; TV = tricuspid valve. Other abbreviations as in Movie clips 1. Movies 2A, 2B, 2D-F, J and K are courtesy of HeartWorks, 2C is courtesy of Virtual Echo Pro(medicalwalkseg.com) and 2G<en dsh>I are courtesy of CT2TEE.
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ISSN:0742-2822
1540-8175
DOI:10.1111/echo.13352