A Prospective Randomized Study to Compare Standard Versus Intensive Training Strategies on Long-term Improvement in Critical Care Ultrasonography Proficiency

Overview

Journal BMC Med Educ

Publisher Biomed Central

Specialty Medical Education

Date 2022 Oct 25

PMID 36280812

Authors

Reina Suzuki

Mio Kanai

Kazumasa Oya

Yohei Harada

Ryohei Horie

Hiroshi Sekiguchi

Affiliations

Soon will be listed here.

Abstract

Background: Critical care ultrasonography (CCUS) has become a daily diagnostic tool for intensivists. While the effective training measures for ultrasound novices are discussed widely, the best curriculum for the novices to retain a long-term proficiency is yet to be determined.

Methods: Critical care medicine fellows who underwent an introductory CCUS workshop were randomly allocated into the standard training (ST) or the intensive training (IT) group. The IT group received an 8-h training besides the standardized fellowship education that the ST group received. Participant improvement in CCUS proficiency tests (maximum score, 200) after a 6-month training intervention was compared between the groups. CCUS examinations performed in patient care were observed over 2 years.

Results: Twenty-one fellows were allocated into the ST (n = 10) or the IT (n = 11) group. No statistically significant difference was observed in the median (interquartile range [IQR]) improvement in CCUS proficiency tests between the ST group and the IT group: 18 (3.8-38) versus 31 (21-46) (P = .09). Median (IQR) test scores were significantly higher in postintervention than preintervention for both groups: ST, 103 (87-116) versus 124 (111-143) (P = .02), and IT, 100 (87-113) versus 143 (121-149) (P < .01). Participating fellows performed 226 examinations over the 2 years of observation.

Conclusions: Fellows improved their CCUS proficiency significantly after 6-month training intervention. However, an additional 8-h training did not provide further benefits.

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References

Ayuela Azcarate J, Clau-Terre F, Vicho Pereira R, Guerrero de Mier M, Carrillo Lopez A, Ochagavia A . [Consensus document on ultrasound training in Intensive Care Medicine. Care process, use of the technique and acquisition of professional skills]. Med Intensiva. 2013; 38(1):33-40. DOI: 10.1016/j.medin.2013.07.003. View

Wong A, Galarza L, Forni L, De Backer D, Slama M, Cholley B . Recommendations for core critical care ultrasound competencies as a part of specialist training in multidisciplinary intensive care: a framework proposed by the European Society of Intensive Care Medicine (ESICM). Crit Care. 2020; 24(1):393. PMC: 7333303. DOI: 10.1186/s13054-020-03099-8. View

Turner E, Fox J, Rosen M, Allen A, Rosen S, Anderson C . Implementation and assessment of a curriculum for bedside ultrasound training. J Ultrasound Med. 2015; 34(5):823-8. DOI: 10.7863/ultra.34.5.823. View

Weiner R, Wang F, Hutter Jr A, Wood M, Berkstresser B, McClanahan C . The feasibility, diagnostic yield, and learning curve of portable echocardiography for out-of-hospital cardiovascular disease screening. J Am Soc Echocardiogr. 2012; 25(5):568-75. DOI: 10.1016/j.echo.2012.01.010. View

Dietrich C, Goudie A, Chiorean L, Cui X, Gilja O, Dong Y . Point of Care Ultrasound: A WFUMB Position Paper. Ultrasound Med Biol. 2016; 43(1):49-58. DOI: 10.1016/j.ultrasmedbio.2016.06.021. View

Rappaport C, McConomy B, Arnold N, Vose A, Schmidt G, Nassar B . A Prospective Analysis of Motor and Cognitive Skill Retention in Novice Learners of Point of Care Ultrasound. Crit Care Med. 2019; 47(12):e948-e952. DOI: 10.1097/CCM.0000000000004002. View

Kimura B, Sliman S, Waalen J, Amundson S, Shaw D . Retention of Ultrasound Skills and Training in "Point-of-Care" Cardiac Ultrasound. J Am Soc Echocardiogr. 2016; 29(10):992-997. DOI: 10.1016/j.echo.2016.05.013. View

Nishiyama C, Iwami T, Murakami Y, Kitamura T, Okamoto Y, Marukawa S . Effectiveness of simplified 15-min refresher BLS training program: a randomized controlled trial. Resuscitation. 2015; 90:56-60. DOI: 10.1016/j.resuscitation.2015.02.015. View

Price S, Via G, Sloth E, Guarracino F, Breitkreutz R, Catena E . Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound. 2008; 6:49. PMC: 2586628. DOI: 10.1186/1476-7120-6-49. View

10.

Sekiguchi H, Suzuki J, Gharacholou S, Fine N, Mankad S, Daniels C . A novel multimedia workshop on portable cardiac critical care ultrasonography: a practical option for the busy intensivist. Anaesth Intensive Care. 2012; 40(5):838-43. DOI: 10.1177/0310057X1204000511. View

11.

Woollard M, Whitfield R, Newcombe R, Colquhoun M, Vetter N, Chamberlain D . Optimal refresher training intervals for AED and CPR skills: a randomised controlled trial. Resuscitation. 2006; 71(2):237-47. DOI: 10.1016/j.resuscitation.2006.04.005. View

12.

Schnobrich D, Olson A, Broccard A, Duran-Nelson A . Feasibility and acceptability of a structured curriculum in teaching procedural and basic diagnostic ultrasound skills to internal medicine residents. J Grad Med Educ. 2014; 5(3):493-7. PMC: 3771182. DOI: 10.4300/JGME-D-12-00214.1. View

13.

Smith K, Gilcreast D, Pierce K . Evaluation of staff's retention of ACLS and BLS skills. Resuscitation. 2008; 78(1):59-65. DOI: 10.1016/j.resuscitation.2008.02.007. View

14.

Beraud A, Rizk N, Pearl R, Liang D, Patterson A . Focused transthoracic echocardiography during critical care medicine training: curriculum implementation and evaluation of proficiency*. Crit Care Med. 2013; 41(8):e179-81. DOI: 10.1097/CCM.0b013e31828e9240. View

15.

OSteen D, Kee C, Minick M . The retention of advanced cardiac life support knowledge among registered nurses. J Nurs Staff Dev. 1996; 12(2):66-72. View

16.

Monsieurs K, De Regge M, Schelfout S, DHondt F, Mpotos N, Valcke M . Efficacy of a self-learning station for basic life support refresher training in a hospital: a randomized controlled trial. Eur J Emerg Med. 2011; 19(4):214-9. DOI: 10.1097/MEJ.0b013e32834af5bf. View

17.

. International consensus statement on training standards for advanced critical care echocardiography. Intensive Care Med. 2014; 40(5):654-66. DOI: 10.1007/s00134-014-3228-5. View

18.

. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med. 2014; 33(11):2047-56. DOI: 10.7863/ultra.33.11.2047. View

19.

Sekiguchi H, Bhagra A, Gajic O, Kashani K . A general Critical Care Ultrasonography workshop: results of a novel Web-based learning program combined with simulation-based hands-on training. J Crit Care. 2012; 28(2):217.e7-12. DOI: 10.1016/j.jcrc.2012.04.014. View

20.

Stross J . Maintaining competency in advanced cardiac life support skills. JAMA. 1983; 249(24):3339-41. View