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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

12.07.2022 | Reports of Original Investigations

Evaluation of an advanced critical care echocardiography program: a mixed methods study

verfasst von: Ghislaine Douflé, MD, MME, Martin Urner, MD, Laura Dragoi, MD, Aditi Jain, MD, Ryan Brydges, MD, PhD, Dominique Piquette, MD, PhD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 10/2022

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Abstract

Purpose

Limited data exist on advanced critical care echocardiography (CCE) training programs for intensivists. We sought to describe a longitudinal echocardiography program and investigate the effect of distributed conditional supervision vs predefined en-bloc supervision, as well as the effect of an optional echocardiography laboratory rotation, on learners’ engagement.

Methods

In this mixed methods study, we enrolled critical care fellows and faculty from five University of Toronto-affiliated intensive care units (ICU) between July 2015 and July 2018 in an advanced training program, comprising theoretical lectures and practical sessions. After the first year, the program was modified with changes to supervision model and inclusion of a rotation in the echo laboratory. We conducted semistructured interviews and investigated the effects of curricular changes on progress toward portfolio completion (150 transthoracic echocardiograms) using a Bayesian framework.

Results

Sixty-five learners were enrolled and 18 were interviewed. Four (9%) learners completed the portfolio. Learners reported lack of time and supervision, and skill complexity as the main barriers to practicing independently. Conditional supervision was associated with a higher rate of submitting unsupervised echocardiograms than unconditional supervision (rate ratio, 1.11, 95% credible interval, 1.08 to 1.14). After rotation in the echocardiography laboratory, submission of unsupervised echocardiograms decreased.

Conclusion

Trainees perceived lack of time and limited access to supervision as major barriers to course completion. Nevertheless, successful portfolio completion was related to factors other than protected time in the echocardiography laboratory or unconditional direct supervision in ICU. Further research is needed to better understand the factors promoting success of CCE training programs.

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Titel: Evaluation of an advanced critical care echocardiography program: a mixed methods study
verfasst von: Ghislaine Douflé, MD, MME
Martin Urner, MD
Laura Dragoi, MD
Aditi Jain, MD
Ryan Brydges, MD, PhD
Dominique Piquette, MD, PhD
Publikationsdatum: 12.07.2022
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 10/2022
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02281-6

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Evaluation of an advanced critical care echocardiography program: a mixed methods study