Competence for transcranial color-coded Duplex sonography is rapidly acquired.

Area of Science:

• Neurosonology
• Intensive Care Medicine
• Medical Education

Background:

• Transcranial color-coded Duplex sonography (TCCD) is a valuable non-invasive bedside diagnostic tool in intensive care.
• Reliable TCCD measurements are crucial, yet operator variability and learning curves remain understudied.
• Assessing TCCD's learning curve and inter-operator agreement is essential for its widespread implementation.

Purpose of the Study:

• To evaluate the learning curve of TCCD for measuring mean cerebral artery (MCA) flow velocities.
• To compare measurement agreement between experienced and inexperienced operators.
• To determine the impact of supervision on TCCD skill acquisition.

Main Methods:

• Six untrained ICU residents and two trained operators performed TCCD examinations on 10 volunteers.
• Trained operators either supervised residents during their first five examinations or conducted them without supervision.
• Measurements from residents were compared against those of trained operators.

Main Results:

• No significant difference in mean flow velocity (MFV) was found between trained and untrained operators (P > 0.78).
• Both supervised and unsupervised groups demonstrated favorable learning curves (ICC ≈ 0.8).
• Supervision accelerated skill acquisition and improved measurement accuracy for trainees (ICC improved from 0.66-0.77 to 0.84-0.91).

Conclusions:

• TCCD of the MCA in volunteers is a readily learnable skill with a positive learning curve.
• A brief training program with initial supervised TCCD measurements ensures reliable results from inexperienced operators.
• TCCD can be effectively implemented in intensive care settings with appropriate training protocols.