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

Abstract

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.

Evaluation of Trainee Competency with Point-of-Care Ultrasonography (POCUS): a Conceptual Framework and Review of Existing Assessments

“…44,51 Another study utilized clinical scenarios and simulators to test a trainee's knowledge and application of knowledge, although their methodology has not been validated. 52 Further investigations are needed to validate and measure knowledge acquisition, application, and integration into clinical practice with bedside echocardiography.…”

Assessing how emergency and trauma ultrasonography is taught to medical students

“…Studies have shown that US techniques are best taught to undergraduate students in emergency and trauma settings. ( 21 - 24 ) The major challenge is to define the best way to offer emergency and trauma US training as part of the medical undergraduate program. In June 2014, the Association for Medical Ultrasound held a forum aimed to design a roadmap for integration of US into the medical education syllabus.…”

Interpretation errors in focused cardiac ultrasound by novice pediatric emergency medicine fellow sonologists

“…Both low and high fidelity ultrasound simulation modalities are available [11]. A 1-day workshop using multi-faceted simulation based education and assessment of focused cardiac ultrasound in the evaluation of the hypotensive patient, showed improved competency in emergency medicine residents [12].…”