Simulator-based transesophageal echocardiographic training with motion analysis: a curriculum-based approach

Area of Science:

• Medical Education
• Cardiovascular Imaging
• Anesthesiology

Background:

• Transesophageal echocardiography (TEE) demands complex motor and cognitive skills.
• Current TEE training relies heavily on extensive clinical time.
• Simulation-integrated TEE training may enhance skill and knowledge acquisition.

Purpose of the Study:

• To evaluate the effectiveness of a simulation-based curriculum for TEE training.
• To assess the ability of kinematic analysis to objectively measure TEE skill development.

Main Methods:

• Echo-naive anesthesia physicians underwent 4 weeks of web-based didactics and biweekly TEE simulator sessions.
• Manual skills were assessed weekly using kinematic analysis of TEE probe motion.
• Simulator-acquired skills were evaluated through intraoperative TEE examinations.

Main Results:

• Kinematic analysis revealed peak movements and path length as predictors of TEE proficiency.
• Trainees initially showed significantly longer path lengths and more peak movements than experts.
• Post-training clinical assessments indicated trainees required more time and performed more transitions than experts.

Conclusions:

• A simulation-based TEE curriculum effectively imparts knowledge and technical skills to beginners.
• Kinematic measures provide an objective method for evaluating manual TEE skill progression.