Goldstein Sheldon, Feierman Dennis E, Samayoa Gabriela M, Roth Ram, Delphin Ellise, Gubenko Yuriy A, Stohl Malka, Rimal Jyotsna, Botea Andrei, Zweig Ronit, Skubas Nikolaos J
J Educ Perioper Med. 2020 Jul 1;22(3):E644. doi: 10.46374/volxxii-issue3-Goldstein. eCollection 2020 Jul-Sep.
Transesophageal echocardiography can be a useful monitor during noncardiac surgery, in patients with comorbidities and/or undergoing procedures associated with substantial hemodynamic changes. The goal of this study was to investigate if transesophageal-echocardiography-related knowledge could be acquired during anesthesia residency.
After institutional review board approval, a prospective observational study was performed in two anesthesiology residency programs. After a 41-week didactic transesophageal-echocardiography-education curriculum residents' exam scores were compared to baseline. The educators' examination was validated against the National Board of Echocardiography's Examination of Special Competence in Advanced Perioperative Transesophageal Echocardiography.
After the 41-week course, clinical anesthesia (CA)-3 exam scores increased 12% compared to baseline ( = .03), CA-2 scores increased 29% ( = .007), and CA-1 scores increased 25% ( = .002). Pearson correlation coefficient between the educators' exam score and the special competence exam percentile rank was 0.69 ( = .006). Pearson correlation coefficient between the educators' exam score and the special competence exam scaled score was 0.71 ( = .0045).
The 41-week course resulted in significant increases in exam scores in all 3 CA-classes. While didactic knowledge can be learned by anesthesiology residents during training, it requires significant time and effort. It is important to educate residents in echocardiography, to prepare them for board examinations and to care for the increasingly older and sicker patient population. Further work needs to be done to determine optimal methods to provide such education.
经食管超声心动图可作为非心脏手术期间合并症患者和/或接受与显著血流动力学变化相关手术患者的有用监测手段。本研究的目的是调查麻醉住院医师培训期间能否掌握经食管超声心动图相关知识。
经机构审查委员会批准，在两个麻醉住院医师培训项目中进行了一项前瞻性观察性研究。在为期41周的经食管超声心动图理论教育课程结束后，将住院医师的考试成绩与基线进行比较。教育者的考试以国家超声心动图委员会的高级围手术期经食管超声心动图特殊能力考试为标准进行验证。
在为期41周的课程结束后，临床麻醉（CA）-3考试成绩较基线提高了12%（P = .03），CA-2成绩提高了29%（P = .00(7)），CA-1成绩提高了25%（P = .00(2)）。教育者考试成绩与特殊能力考试百分位排名之间的Pearson相关系数为0.69（P = .00(6)）。教育者考试成绩与特殊能力考试量表分数之间的Pearson相关系数为(0.71)（P = .00(45)）。
为期41周的课程使所有三个CA级别考试成绩显著提高。虽然麻醉住院医师在培训期间可以学习理论知识，但这需要大量时间和精力。对住院医师进行超声心动图教育很重要，可为他们参加委员会考试及护理日益增多的老年和病情较重患者群体做好准备。需要进一步开展工作以确定提供此类教育的最佳方法。
