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Acceleration of the learning curve for mastering basic critical care echocardiography using computerized simulation.

Authors :
Vignon P
Pegot B
Dalmay F
Jean-Michel V
Bocher S
L'her E
Cros J
Prat G
Source :
Intensive care medicine [Intensive Care Med] 2018 Jul; Vol. 44 (7), pp. 1097-1105. Date of Electronic Publication: 2018 Jun 21.
Publication Year :
2018

Abstract

Purpose: To assess the impact of computerized transthoracic echocardiography (TTE) simulation on the learning curve to achieve competency in basic critical care echocardiography (CCE).<br />Methods: In this prospective bicenter study, noncardiologist residents novice in ultrasound followed either a previously validated training program with adjunctive computerized simulation on a mannequin (two 3 h-sessions; Vimedix simulator, CAE Healthcare) (interventional group; n = 12) or solely the same training program (control group; n = 12). All trainees from the same institution were assigned to the same study group to avoid confusion bias. Each trainee was evaluated after 1 (M1), 3 (M3) and 6 (M6) months of training using our previously validated scoring system. Competency was defined by a score ≥ 90% of the maximal value.<br />Results: The 24 trainees performed 965 TTE in patients with cardiopulmonary compromise during their 6-month rotation. Skills assessments relied on 156 TTE performed in 106 patients (mean age 53 ± 14 years; mean Simplified Acute Physiologic Score 2: 55 ± 19; 79% ventilated). When compared to the control group, trainees of the interventional group obtained a significantly higher mean skills assessment score at M1 (41.5 ± 4.9 vs. 32.3 ± 3.7: P = 0.0004) and M3 (45.8 ± 2.8 vs. 42.3 ± 3.7: P = 0.0223), but not at M6 (49.7 ± 1.2 vs. 50.0 ± 2.7: P = 0.6410), due to higher practical and technical skills scores. Trainees of the control group required significantly more supervised TTE to obtain competency than their counterparts (36 ± 7 vs. 30 ± 9: p = 0.0145).<br />Conclusions: Adjunctive computerized simulation accelerates the learning curve of basic CCE in improving practical and technical skills and reduces the number of TTE examinations required to reach competency.

Details

Language :
English
ISSN :
1432-1238
Volume :
44
Issue :
7
Database :
MEDLINE
Journal :
Intensive care medicine
Publication Type :
Academic Journal
Accession number :
29931488
Full Text :
https://doi.org/10.1007/s00134-018-5248-z