2014

HomeProfessionalsCareer DevelopmentFellowsInnovations in Fellowship Education2014 ▶ A Structured Training Program in Basic Critical Care Echocardiography Incorporating Didactic, Simulation and Bedside Teaching to Promote Clinical Competence
A Structured Training Program in Basic Critical Care Echocardiography Incorporating Didactic, Simulation and Bedside Teaching to Promote Clinical Competence

University of Vermont
Burlington, VT

Abstract Title: 

Program Director: David Kaminsky, MD
Associate Program Director: Benjamin Suratt, MD
Type of Program: Division of Pulmonary and Critical Care Medicine
Abstract Authors: Alan C. Lee, MD, Laurie Leclair, MD, Joshua Farkas, MD, Ryan Clouser, DO,
Mark Hamlin, MD, Patrick Bender, MD


RATIONALE
Echocardiography has become an essential tool for the assessment and care of critically ill patients, and fellows must demonstrate competence. However, academic faculty often lack formal training in critical care echocardiography and short intensive courses available for faculty or trainees may not result in competency required to teach and perform echocardiography.


METHODS
Guided by current literature on training standards, we developed a 12 month institution-based focused bedside critical care echocardiography curriculum for faculty and fellows consisting of 3 components; lectures, standardized patient exams, and weekly bedside practice sessions. The curriculum is supervised and taught by established local Medicine and Anesthesia experts in focused critical care echocardiography. The first 6 months of the curriculum are focused on image acquisition technique and the second 6 months on image interpretation. Participants are required to attend all lectures, participate in a 2 hour standardized patient session, and attend 7 one-hour bedside practice sessions. Once these components are complete, participants are required to perform 30 independent exams documented by a case log. Competency of individual participants will then be assessed by a written final exam and two directly observed bedside exams where they will be evaluated for image quality and interpretation.


RESULTS
10 faculty and 6 fellows are participating in our training curriculum. Six months into our training curriculum, all lectures and simulation lab sessions are complete and have been attended by 100% of participants. One-hour bedside practice sessions are occurring weekly in our ICU, and faculty and fellows have completed an average of 2 of the 7 required sessions ranging from 0 to 7 session completed individually. We expect final assessments to begin on June of 2014.


CONCLUSIONS
Implementation of our curriculum is feasible and has provided uniform training in focused basic critical care echocardiography for faculty and fellows. Successful completion of the course will confirm competency of the participants and will provide a foundation for institutional credentialing and long term maintenance of competency. Future directions include determining if training in critical care echocardiography impacts utilization of formal echocardiograms and provides long-term competence.


REFERENCES
1. Audrey De Jong, Nicolas Molinari, Nicolas Terzi, Nicolas Mongardon, Jean-Michel Arnal, et al. Early Identification of Patients at Risk for Difficult Intubation in the Intensive Care Unit, Development and Validation of the MACOCHA Score in a Multicenter Cohort Study. Am J Respir Crit Care Med 2013;187(8):832–839.
2. Yasuharu Okuda, MD, Ethan O. Bryson, MD, Samuel DeMaria Jr, MD, et al. The Utility of Simulation in Medical Education: What Is the Evidence? Mount Sinai Journal of Medicine 76:330–343, 2009 330
3. Pastis NJ, Nietert PJ, Silvestri GA; American College of Chest Physicians Interventional Chest/Diagnostic Procedures Network Steering Committee. Variation in training for interventional pulmonary procedures among US pulmonary/critical care fellowships: a survey of fellowship directors. Chest 2005;127(5):1614-1621.
4. Snyder CW, Vandromme MJ, Tyra SL, et al. Retention of colonoscopy skills after virtual reality simulator training by independent and proctored methods. Am Surg 2010;76:743E6.

 

Last Reviewed: July 2016