Abstract P68: The Emergency Echocardiography Simulation Test (EmEchoSimTest TM): How to assess trainees’ competence in visual diagnoses?
INTRODUCTION: In peri-resuscitation care, i.e. hypotension, cardiac arrest states and post-resuscitation care, potentially treatable causes are to be identified against time. We introduced a training concept on focused echocardiography entry level (FEEL) for minimally trained operators such as intensivists (INT) or emergency physicians (EP). An essential skill is to interpret trans-thoracical echocardiography (TTE) exams as “visual diagnoses” of within seconds.
METHODS: We developed the “Emergency Echocardiography Simulation Test” which contains 15 echocardiography .mpeg movie clips with ten distinct differential diagnoses. It includes normal and pathologic findings such as pericardial effusion, reduced ventricular function, pulseless electrical activity and hypovolemia. Each test block consists of one clip lasting at most 60 sec, a free text box (FTB) to type in firstly the suspected diagnosis followed by a multiple choice question (MCQ). INT or EP could view the loops only once. There was no “back”, “pause” or “stop” function. We prospectively defined test responders (TR) as those who scored more than 50% of the combined FTB and MCQ answers. Time consumption and numbers or percentages of right answers in FTB and MCQ were measured.
RESULTS: Of n=71 INT/EP, n=44 were TR. Mean scores of correctly interpreted TTE echocardiograms were: FTB 10,5 (65,8±18,7%), MCQ 10,9 (68,0±12,3%) for TR and FTB 2,2 (13,9±13,5%), MCQ 8,9 (55,6±13,7%) for non-TR (numbers indicate positive answers and percentage with SD, respectively). The best-detected pathologic findings were: Pericardial tamponade 66,3% and pleural effusion 71,8%. Mean time elapsed to give a correct FTB answer was 33,8 sec ±7,2 for TR and 33,0 sec ±12,9 for non-TR.
CONCLUSIONS: This EmEchoSimTestTM demonstrated to be a valuable tool to assess the INT/EP individual knowledge patterns and can differentiate their TTE recognition skills to obtain visual diagnoses. It may support basic level trainee competency assessment on focused echocardiography in critical care medicine and educational programs as quality assurance if they sufficiently submit such knowledge.