Swerdlow Barry, Osborne-Smith Lisa, Soelberg Julie
Nurse Anesthesia Program, Oregon Health & Science University, Portland, OR, USA.
Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA.
J Med Educ Curric Dev. 2024 Feb 1;11:23821205241229001. doi: 10.1177/23821205241229001. eCollection 2024 Jan-Dec.
The use of transesophageal echocardiography (TEE) by certified registered nurse anesthetists (CRNAs) during noncardiac surgery is relatively uncommon despite its unique potential to diagnose causes of hemodynamic instability. To address this problem, educational endeavors designed to provide practical TEE skills to CRNAs are needed. The aim of the current study was to evaluate the feasibility, acceptability, efficacy, and utility of a 2-day focused TEE workshop in nurse anesthesia education that employed a protocol involving a limited number of views and used goal-directed, qualitative assessments of critical physiologic parameters.
This was a prospective, observational study involving 14 second-year nurse anesthesia students. The cohort was evaluated following completion of this workshop by simulator-based testing involving hypothetical clinical scenarios, and this test data was analyzed according to the percent successful acquisition and interpretation of TEE views to determine immediate objective teaching efficacy. The acceptability, perceived efficacy, and perceived utility of the workshop were assessed by online survey, and survey responses were qualitative and quantitative in nature.
Participants acquired appropriate TEE views associated with clinical scenarios 99% of the time and correctly interpreted the pathology in those views 93% of the time. Participants uniformly perceived significant educational value in this workshop and intend to incorporate TEE in their future clinical practice.
A 2-day workshop to teach focused TEE to nurse anesthesia trainees directed by a streamlined protocol is feasible, acceptable, and perceived as useful by participants, and provides practical experience and entry-level competency in this point-of-care ultrasound modality.
尽管经食管超声心动图（TEE）在诊断血流动力学不稳定原因方面具有独特潜力，但在非心脏手术期间由认证注册护士麻醉师（CRNA）使用该技术的情况相对较少。为解决这一问题，需要开展旨在为CRNA提供实用TEE技能的教育活动。本研究的目的是评估一个为期两天的聚焦TEE工作坊在护士麻醉教育中的可行性、可接受性、有效性和实用性，该工作坊采用了一个涉及有限数量视图的方案，并对关键生理参数进行目标导向的定性评估。
这是一项前瞻性观察性研究，涉及14名二年级护士麻醉专业学生。在完成该工作坊后，通过基于模拟临床场景的测试对该队列进行评估，并根据TEE视图成功获取和解读的百分比对测试数据进行分析，以确定即时客观教学效果。通过在线调查评估该工作坊的可接受性、感知效果和感知实用性，调查回复兼具定性和定量性质。
参与者在99%的时间内获取了与临床场景相关的适当TEE视图，并在93%的时间内正确解读了这些视图中的病理情况。参与者一致认为该工作坊具有显著的教育价值，并打算在未来的临床实践中应用TEE。
由简化方案指导的、为期两天的向护士麻醉学员教授聚焦TEE的工作坊是可行的、可接受的，且参与者认为是有用的，并提供了这种床旁超声模式的实践经验和入门级能力。
