Effectiveness of a Critical Care Ultrasonography Course

Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

“…Practical skill test after 60 min hands-on session (four cases)Porcine modelsOne and a half hour theoretical and practice-based courseFour veterinaries, eight neonatologists, seven paediatric intensive care specialists, two intensive care nurses, three paediatric surgeons, eight paediatric anaesthesiologists, four paediatricians See et al [23]Pre- and post-testTheoretical pre- and post-test (20 MCQs) and hands-on (blinded evaluation of image acquisition and interpretation)Mechanically ventilated patients or patients with respiratory failure, requiring at least 40% inspired oxygen fraction to maintain an oxygen saturation of 90%30 min didactic introduction, 1 month self-study (powerpoint slides, criticalecho.com and court.net). Supervised scans with immediately feedback with focus on image acquisition, afterwards image interpretation by blinded observer22 respiratory therapists Greenstein et al [24]Pre- and post-testTheoretical pre- and post-test (20 MCQs) and hands-on assessmentHealthy human models3 days course including didactic lectures with real-time ultrasound scan on healthy models, image interpretation sessions and hands-on training363 critical care physicians, hospitalists, surgeons, physician assistants, advanced practice nurses and medical residentsDescriptive studies Krishnan et al [25]Post course evaluation and sustainability testTheoretical post- and sustainability test (20 video clips ± pneumothorax)Ultrasound video of 53 patients before and after elective thoracic surgery. In all, 99 videos were compiled (52 without pneumothoraces and 47 with)5-min online presentation of the use of ultrasound for detection of pneumothorax79 (70 at 6 month follow-up) residents and faculty members from Department of anaesthesiaAbbasi et al [26]Prospective cross-sectional studyHands-on assessment (± pneumothorax)Healthy live models and patients admitted in Emergency Department with thoracic trauma2 h training course including 30 min didactic lecture, 30 min hands-on training on healthy volunteers, 1 h training on patientsFour emergency physiciansGargani et al [27]Post course evaluationOnline assessment of uploaded LUS examinations and theoretical assessment of b -line interpretation (44 videos)PatientsPart A: web-based training program; 26 min educational video with focus on b -line assessment.…”

“…Three patients block (36 images) Overall performance score with linear regressionImprovement in pre- and post-test scores and practical skill scoresWe devised a pragmatic lung ultrasound curriculum, which involved building rapport, stimulating self-directed learning, and avoiding cognitive overload. Our training method allowed RTs to acquire the ability to independently perform lung ultrasound after at least ten directly supervised scans4Greenstein et al [24]. Effectiveness of a Critical Care ultrasonography Course.…”

“…In total, there were 12 pre- and post-test studies that used improvement in written test scores to evaluate the educational Cochrane [13–24]. Five of the pre- and post-test studies had a follow-up time from 1 week to 6 months, average 13 weeks ± 4.83 [14, 16, 18, 20, 25], and one recorded number of scans performed from baseline to follow-up [20].…”

“…Three descriptive studies were identified [25–27] and one randomized controlled trial [28]. Five of the studies (31%) were courses in general critical care ultrasound, or basic skill ultrasound, where thoracic or lung ultrasound was a specific and independently evaluated topic [17, 19–21, 24]. …”

“…Three studies also included other healthcare professionals as prehospital providers, nurses, and veterinarians [18, 22, 24]. Two studies excluded participants with the previous ultrasound certification or attendance in a formal critical care ultrasound course within 12 months [20, 28], and two studies only included a study population with no experience [21, 24]. …”