A Brief Training Module Improves Recognition of Echocardiographic Wall-Motion Abnormalities by Emergency Medicine Physicians

Kerwin, Chris; Tommaso, Laura; Kulstad, Erik

doi:10.1155/2011/483242

Cited by 18 publications

(14 citation statements)

References 26 publications

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“… 7 , 8 Proctored US hands-on instruction and training modules have been shown to positively impact US training; however, to our knowledge, US-focused simulation-based training has not been studied before. 9 , 10 This study evaluated a novel simulation-based US educational and assessment workshop.…”

Section: Introductionmentioning

confidence: 99%

Point-of-care echocardiography in simulation-based education and assessment

Amini¹,

Stolz²,

Javedani³

et al. 2016

AMEP

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BackgroundEmergency medicine milestones released by the Accreditation Council for Graduate Medical Education require residents to demonstrate competency in bedside ultrasound (US). The acquisition of these skills necessitates a combination of exposure to clinical pathology, hands-on US training, and feedback.ObjectivesWe describe a novel simulation-based educational and assessment tool designed to evaluate emergency medicine residents’ competency in point-of-care echocardiography for evaluation of a hypotensive patient with chest pain using bedside US.MethodsThis was a cross-sectional study conducted at an academic medical center. A simulation-based module was developed to teach and assess the use of point-of-care echocardiography in the evaluation of the hypotensive patient. The focus of this module was sonographic imaging of cardiac pathology, and this focus was incorporated in all components of the session: asynchronous learning, didactic lecture, case-based learning, and hands-on stations.ResultsA total of 52 residents with varying US experience participated in this study. Questions focused on knowledge assessment demonstrated improvement across the postgraduate year (PGY) of training. Objective standardized clinical examination evaluation demonstrated improvement between PGY I and PGY III; however, it was noted that there was a small dip in hands-on scanning skills during the PGY II. Clinical diagnosis and management skills also demonstrated incremental improvement across the PGY of training.ConclusionThe 1-day, simulation-based US workshop was an effective educational and assessment tool at our institution.

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Section: Introductionmentioning

confidence: 99%

Point-of-care echocardiography in simulation-based education and assessment

Amini¹,

Stolz²,

Javedani³

et al. 2016

AMEP

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show abstract

“…To our knowledge, there exists only one paper evaluating the ability of non-cardiologist clinicians to diagnose wall-motion abnormalities. This study showed that a 30-minute training module significantly improved the ability of emergency physicians to identify wall motion abnormalities (53). Though this has not been studied directly, we postulate that a negative exam performed and interpreted by a non-cardiologist clinician, given the skill required in image acquisition and interpretation, does not rule out the presence of wall motion abnormalities.…”

Section: Wall Motion Abnormalities Q: Is There Any Obvious Wall Motiomentioning

confidence: 72%

Resuscitative EChocardiography for the Evaluation and management of Shock: The RECES protocol

Mosier¹,

Stolz²,

Bloom³

et al. 2014

Southwest J Pulm Crit Care

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Purpose: Ultrasound use by emergency medicine and critical care physicians in the evaluation of the critically ill patient has increased in recent years. Several protocols exist to aid in diagnosing the etiology of shock and identifying rapidly reversible conditions in the undifferentiated hypotension patient. Currently, no protocol provides hemodynamic data or is designed to guide ongoing resuscitation of the critically ill patient with hypotension.Methods: An evidence-based protocol was developed based on the components of echocardiography that have been supported in the literature for bedside evaluation of the critically ill patient. Results:The RECES protocol provides diagnostic and hemodynamic information regarding volume responsiveness , presence of pericardial effusion with tamponade physiology (right ventricular diastolic collapse), systolic failure (poor contractility, decreased stroke volume and cardiac output), diastolic dysfunction (mitral valve inflow velocities and tissue Doppler), Right ventricular systolic failure, acute valvular rupture, obvious wall motion abnormalities, and signs of pressure or volume overload (septal flattening on parasternal short axis). Conclusion:The RECES protocol is a proposed instrument for rapidly and repeatedly assessing the etiology and initial hemodynamic parameters of the patient in shock. Additionally, repeated exams will allow monitoring interventions and guide ongoing resuscitation.

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“… 7 , 9 , 17 However, one prospective study did show that basic echocardiography training for emergency department physicians greatly improved their ability to interpret WMAs. 18 Two previous case series evaluating the use of point-of-care echocardiography by emergency department physicians concluded that echocardiography can provide a rapid detailed assessment of WMAs that may help speed clinical decision-making. 19 , 20 Detecting early WMAs may be imperative, as these occur even before electrocardiographic changes or chest pain in patients with ACS.…”

Section: Discussionmentioning

confidence: 99%