Effectiveness of a Perioperative Transthoracic Ultrasound Training Program for Students and Residents

• Published in: Journal of surgical education Vol. 74; no. 5; pp. 805 - 810
• Main Authors: Ray, Juliet June, MD, MSPH, Meizoso, Jonathan P., MD, MSPH, Hart, Valerie, DO, Horkan, Davis, MD, Behrens, Vicente, MD, Rao, Krishnamurti A., MD, MPH, Karcutskie, Charles A., MD, MA, Lenchus, Joshua, DO, Schulman, Carl I., MD, PhD, MSPH, FACS, Dudaryk, Roman, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017
• Subjects: Anesthesiology - education; Clinical Competence; Clinical Medicine - education; Cohort Studies; course; Echocardiography; education; Education, Medical, Graduate - methods; Education, Medical, Undergraduate - methods; Female; focus assessed transthoracic echocardiography; General Surgery - education; Humans; Internship and Residency - statistics & numerical data; Male; Medical Knowledge; Patient Care; Perioperative Care; Pilot Projects; Practice-Based Learning and Improvement; Prospective Studies; sonography; Students, Medical - statistics & numerical data; Surgery; ultrasound; United States; Patient Care; education; focus assessed transthoracic echocardiography; Medical Knowledge; course; Practice-Based Learning and Improvement; ultrasound; sonography
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2017.02.005

Objective Focused ultrasound (US) is being incorporated across all levels of medical education. Although many comprehensive US courses exist, their scope is broad, requiring expert instructors, access to simulation, and extensive time commitment by the learner. We aim to compare learning across levels of training and specialties using a goal-directed, web-based course without live skills training. Design A prospective observational study of students and residents from medicine, surgery, and anesthesiology. Analysis compared pretests and posttests assessing 3 competencies. Individual mean score improvement (MSI) was compared by paired-sample t -tests and MSI among cohorts by analysis of variance, with significance set at p ≤ 0.05. McNemar test compared those who agreed or strongly agreed with survey items with those who did not before and after intervention. Setting Jackson Memorial Hospital, Miami, FL residency training programs in Medicine, Surgery, and Anesthesiology. Results A total of 180 trainees participated. A significant MSI was noted in each of 3 competencies in all 3 cohorts. Students’ ( S ) MSI was significantly higher than residents’ ( R ) and interns’ ( I ) in US “knobology” and window recognition [ S = 2.28 ± 1.29/5 vs R = 1.63 ± 1.21/5 (p = 0.014); vs I = 1.59 ± 1.12/5 (p = 0.032)]; students’ total score MSI was significantly higher than residents [7.60 ± 3.43/20 vs 5.78 ± 3.08/20 (p < 0.008)]. All cohorts reported improved comfort in using transthoracic US and improved ability to recognize indications for use. More than 81% of all participants reported improved confidence in performing transthoracic US; more than 91% reported interest in additional training; and more than 88% believed course length was appropriate. Conclusions Learners across levels of medical training and specialties can benefit from a brief, goal-directed, web-based training with early incorporation producing maximal yield.