Asynchronous simulation-based training of resuscitative transesophageal echocardiography in emergency physicians

Emergency physicians are increasingly utilizing transesophageal echocardiography in the emergency department (ED) when caring for critically ill patients. Simulation-based transesophageal echocardiography training has been shown to be an effective learning tool. This study evaluated whether a brief asynchronous learning module combined with simulation-based practice is effective for emergency physicians who are already experienced in point-of-care ultrasound (PoCUS).

We conducted a prospective study of emergency physicians with PoCUS experience at a single ED. Participants viewed a 30-min asynchronous module on transesophageal echocardiography in the ED and reviewed a four-view resuscitative protocol. They then completed a baseline simulation assessment, a brief guided practice session, and a post-intervention assessment. All views were recorded. The primary outcome was the proportion of successful transesophageal echocardiography views, scored by two blinded reviewers.

Twenty emergency physicians completed the study. The mean age was 39 years, 6 participants (30%) were female, the median clinical experience was 5.5 years, and all participants had PoCUS experience. The percentage of total successful views increased from 63% (95% CI 52-72%) at baseline to 93% (84-97%; p < 0.001) after guided practice.

A brief 30-min asynchronous module combined with focused simulation-based training was effective in immediately improving the acquisition of core resuscitative transesophageal echocardiography views among emergency physicians with PoCUS experience. Future studies are needed to determine whether this approach leads to sustained skill retention and improved integration of resuscitative transesophageal echocardiography into clinical practice.