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Open Access Research article

Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners

Christian Alcaraz Frederiksen13*, Peter Juhl-Olsen13, Dorte Guldbrand Nielsen23, Berit Eika23 and Erik Sloth13

  • * Corresponding author: Christian A Frederiksen caf@ki.au.dk

Author Affiliations

1 Department of Anesthesiology and Intensive care, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark

2 Unit for Medical Education, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark

3 Institute of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark

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BMC Medical Education 2012, 12:65  doi:10.1186/1472-6920-12-65

Published: 3 August 2012

Abstract

Background

Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation.

Methods

Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed.

Results

At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9).

Conclusions

Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.

Keywords:
Point-of-care; Bedside; Ultrasound; Echocardiography; Learning