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Evaluation of the quality of transesophageal echocardiography images and verification of proficiency

Echo Research & Practice volume 5, pages 89–95 (2018)Cite this article

Abstract

Various metrics have been used in curriculum-based transesophageal echocardiography (TEE) training programs to evaluate acquisition of proficiency. However, the quality of task completion, that is the final image quality, was subjectively evaluated in these studies. Ideally, the endpoint metric should be an objective comparison of the trainee-acquired image with a reference ideal image. Therefore, we developed a simulator-based methodology of preclinical verification of proficiency (VOP) in trainees by tracking objective evaluation of the final acquired images. We utilized geometric data from the simulator probes to compare image acquisition of anesthesia residents who participated in our structured longitudinal simulator-based TEE educational program vs ideal image planes determined from a panel of experts. Thirty-three participants completed the study (15 experts, 7 postgraduate year (PGY)-1 and 11 PGY-4). The results of our study demonstrated a significant difference in image capture success rates between learners and experts (χ2 = 14.716, df = 2, P < 0.001) with the difference between learners (PGY-1 and PGY-4) not being statistically significant (χ2 = 0, df = 1, P = 1.000). Therefore, our results suggest that novices (i.e. PGY-1 residents) are capable of attaining a level of proficiency comparable to those with modest training (i.e. PGY-4 residents) after completion of a simulation-based training curriculum. However, professionals with years of clinical training (i.e. attending physicians) exhibit a superior mastery of such skills. It is hence feasible to develop a simulator-based VOP program in performance of TEE for junior anesthesia residents.

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Funding

The primary author, Robina Matyal, MD received funding from a FAER Research in Education grant.

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Authors and Affiliations

  1. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

    Robina Matyal MD, Stephanie B. Jones MD, Rabia Amir MD, Ruma Bose MD & John D. Mitchell MD

  2. Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

    Faraz Mahmood MD & Ziyad Omar Knio BS

  3. Department of Anesthesia and Critical Care Medicine, University Medical Center Groningen, Groningen, the Netherlands

    Lu Yeh MD

Authors
  1. Robina Matyal MD
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  2. Faraz Mahmood MD
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  3. Ziyad Omar Knio BS
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  4. Stephanie B. Jones MD
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  5. Lu Yeh MD
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  6. Rabia Amir MD
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  7. Ruma Bose MD
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  8. John D. Mitchell MD
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Corresponding author

Correspondence to Faraz Mahmood MD.

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Matyal, R., Mahmood, F., Knio, Z.O. et al. Evaluation of the quality of transesophageal echocardiography images and verification of proficiency. Echo Res Pract 5, 89–95 (2018). https://doi.org/10.1530/ERP-18-0002

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  • DOI: https://doi.org/10.1530/ERP-18-0002

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Echo Research & Practice

ISSN: 2055-0464

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