Acceleration of the learning curve for mastering basic critical care echocardiography using computerized simulation

To assess the impact of computerized transthoracic echocardiography (TTE) simulation on the learning curve to achieve competency in basic critical care echocardiography (CCE).

In this prospective bicenter study, noncardiologist residents novice in ultrasound followed either a previously validated training program with adjunctive computerized simulation on a mannequin (two 3 h-sessions; Vimedix simulator, CAE Healthcare) (interventional group; n = 12) or solely the same training program (control group; n = 12). All trainees from the same institution were assigned to the same study group to avoid confusion bias. Each trainee was evaluated after 1 (M1), 3 (M3) and 6 (M6) months of training using our previously validated scoring system. Competency was defined by a score ≥ 90% of the maximal value.

The 24 trainees performed 965 TTE in patients with cardiopulmonary compromise during their 6-month rotation. Skills assessments relied on 156 TTE performed in 106 patients (mean age 53 ± 14 years; mean Simplified Acute Physiologic Score 2: 55 ± 19; 79% ventilated). When compared to the control group, trainees of the interventional group obtained a significantly higher mean skills assessment score at M1 (41.5 ± 4.9 vs. 32.3 ± 3.7: P = 0.0004) and M3 (45.8 ± 2.8 vs. 42.3 ± 3.7: P = 0.0223), but not at M6 (49.7 ± 1.2 vs. 50.0 ± 2.7: P = 0.6410), due to higher practical and technical skills scores. Trainees of the control group required significantly more supervised TTE to obtain competency than their counterparts (36 ± 7 vs. 30 ± 9: p = 0.0145).

Adjunctive computerized simulation accelerates the learning curve of basic CCE in improving practical and technical skills and reduces the number of TTE examinations required to reach competency.