From the Department of Anesthesiology (J.S.B., J.S.S.), and Department of Biostatistics (Y.S., J.S.S.), School of Medicine, Vanderbilt University; and Department of Anesthesiology (J.D.K., C.E.W.), Vanderbilt University Medical Center Nashville, TN; Department of Anesthesiology (S.D.M., A.D.S., M.M.W., A.I.L.), Icahn School of Medicine at Mount Sinai, New York, NY.
Simul Healthc. 2013 Oct;8(5):329-34. doi: 10.1097/SIH.0b013e31829068df.
Training in transesophageal echocardiography (TEE) requires a significant commitment of time and resources on behalf of the trainees and the instructors. Training opportunities may be limited in the busy clinical environment. Medical simulation has emerged as a complementary means by which to develop clinical skills. Transesophageal echocardiography simulators have been commercially available for several years, yet their ability to distinguish experts from novices has not been demonstrated. We used a standardized assessment tool to distinguish experts from novices using a commercially available TEE simulator.
Anesthesiologists certified in advanced perioperative TEE and anesthesiology resident physicians were recruited into the expert and novice cohorts, respectively. The cohorts were recruited from 2 academic medical centers. The novice cohort received a structured introduction to the basic TEE examination. Both cohorts then proceeded to perform a basic TEE examination involving normal cardiac anatomy, which was evaluated by blinded raters using a standardized assessment tool.
The expert cohort consistently demonstrated the ability to obtain standard TEE imaging views in less time and more accurately than the novice cohort during the course of a simulated TEE examination.
A simulated transesophageal examination of normal cardiac anatomy in concert with a standardized assessment tool permits ample discrimination between expert and novice echocardiographers as defined for this investigation. Future research will examine in detail the role echocardiography simulators should play during echocardiography training including assessment of training level.
经食管超声心动图（TEE）的培训需要学员和讲师投入大量的时间和资源。在繁忙的临床环境中，培训机会可能有限。医学模拟已成为发展临床技能的一种补充手段。经食管超声心动图模拟器已经商业化多年，但它们区分专家和新手的能力尚未得到证明。我们使用标准化评估工具，使用商业上可用的 TEE 模拟器来区分专家和新手。
经过高级围手术期 TEE 和麻醉学住院医师认证的麻醉师分别被招募到专家和新手队列中。这两个队列都是从 2 家学术医疗中心招募的。新手队列接受了基础 TEE 检查的结构化介绍。然后，两个队列都进行了基本的 TEE 检查，涉及正常心脏解剖结构，由盲法评估者使用标准化评估工具进行评估。
在模拟 TEE 检查过程中，专家队列始终比新手队列更能在更短的时间内更准确地获得标准 TEE 成像视图。
正常心脏解剖结构的模拟经食管检查与标准化评估工具相结合，可充分区分本研究定义的专家和新手超声心动图医师。未来的研究将详细研究超声心动图模拟器在超声心动图培训中应发挥的作用，包括培训水平的评估。
