Pulmonary and Critical Care Medicine, 3989Baylor College of Medicine, Ben Taub General Hospital, Houston, TX, USA.
Division of Pulmonary, Critical Care and Sleep Medicine, 12289University of New Mexico SOM, Albuquerque, NM, USA.
J Intensive Care Med. 2020 Nov;35(11):1332-1337. doi: 10.1177/0885066619867678. Epub 2019 Aug 13.
Advanced critical care echocardiography (CCE) involves comprehensive assessment of cardiac structure and function for frontline critical care applications. This study reports the effectiveness of a 3-day course in advanced CCE.
We studied the outcome of 5 consecutive advanced CCE courses delivered between 2013 and 2017. A total number of 239 learners were studied. The course included didactic lectures, image interpretation sessions, and hands-on training with normal individuals as models. Training domains included left ventricular structure and function, right ventricular structure and function, valve function using comprehensive 2-dimensional imaging, and Doppler-based measurements for cardiac pressures and flows. Measurements of course outcome included pre- and postcourse assessment of knowledge, image acquisition, and image interpretation skills. Learners rotated between hands-on training and interpretation sessions. The teacher-to-learner ratio was 1:3 during hands-on training. Interpretation sessions consisted of review of normal and abnormal echocardiographic videos with interactive small groups. Learners completed a video-based knowledge assessment examination before and after completion of the course. Hands-on image acquisition skills were tested at the completion of the course during all the years. For years 2016 and 2017, a precourse hands-on skill test was also performed.
There was a statistically significant improvement in knowledge and image interpretation skills in the cohort of 239 learners over 5 years of study period. There was improvement in image acquisition skills over the 2-year period when it was measured pre- and postcourse.
A 3-day course on advanced CCE resulted in improvement knowledge/image interpretation and hands-on image acquisition skills. Advanced CCE has assumed an important place in hemodynamic monitoring of critically ill patients. A course of similar design may facilitate training of frontline clinicians in advanced CCE.
高级重症监护超声心动图（CCE）涉及对心脏结构和功能的全面评估，适用于一线重症监护应用。本研究报告了为期 3 天的高级 CCE 课程的效果。
我们研究了 2013 年至 2017 年间连续举办的 5 期高级 CCE 课程的结果。共有 239 名学员参加了研究。该课程包括理论讲座、图像解读课程和以正常人为模型的实操培训。培训领域包括左心室结构和功能、右心室结构和功能、使用综合二维成像评估瓣膜功能，以及基于多普勒的心脏压力和流量测量。课程结果的测量包括课程前后的知识、图像采集和图像解读技能评估。学员在实操培训和解读课程之间轮流进行。实操培训期间，教师与学员的比例为 1:3。解读课程包括正常和异常超声心动图视频的回顾，学员分成小组进行互动。学员在课程结束前后完成了基于视频的知识评估考试。在所有年份，实操图像采集技能在课程结束时进行测试。在 2016 年和 2017 年，还在课程前进行了实操技能预测试。
在 5 年的研究期间，239 名学员的知识和图像解读技能有统计学显著提高。当在课程前后进行测量时，图像采集技能在 2 年内得到了提高。
为期 3 天的高级 CCE 课程可提高学员的知识/图像解读和实操图像采集技能。高级 CCE 在重症患者血流动力学监测中占有重要地位。类似设计的课程可能有助于培训一线临床医生掌握高级 CCE。
