Evaluation of a training course in focused echocardiography for noncardiology house officers

Authors


  • The authors declare no conflict of interest.

  • Presented in part at the 18th International Veterinary Emergency and Critical Care Symposium, San Antonio, TX, September 2012.

Address correspondence and reprint requests to

Dr. John E. Rush, Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, 200 Westboro Rd, North Grafton, MA 01536, USA.

Email: john.rush@tufts.edu

Abstract

Objective

To determine whether a training course in focused echocardiography can improve the proficiency of noncardiology house officers in accurately interpreting cardiovascular disease and echocardiography findings in dogs entering the emergency room setting.

Design

Prospective, blinded, educational study.

Setting

University veterinary teaching hospital.

Study Subjects

House officers underwent training in focused echocardiography. Fifteen dogs, including normal dogs and dogs with stable congenital or acquired cardiac disease, were used as study subjects during the laboratory session.

Interventions

A 6-hour curriculum on focused echocardiography was developed that included didactic lectures, clinical cases, and hands-on echocardiography.

Measurements and Main Results

Pre- and postcourse written examinations were administered to participants. House officers attended didactic lectures that were subsequently followed by a hands-on laboratory session and practical examination, which involved performing transthoracic echocardiography on dogs with and without cardiovascular disease. Twenty-one house officers completed the focused echocardiography training course. Written examination scores were 57 ± 12% before and 75 ± 10% after training (P < 0.001). Following the course, 97% of participants in the practical examination were able to obtain the correct right parasternal short- or long-axis view. Posttraining, most participants correctly identified pleural effusion (90%) and pericardial effusion (95%) and discriminated normal atrial size from atrial enlargement (86%). However, successful identification of a cardiac mass, volume status, and ability to recognize a poor quality study as nondiagnostic remained relatively low. Most trainees responded that the length of hands-on laboratory training was too abbreviated and that the course should be > 6 hours.

Conclusion

A focused echocardiography training course improved knowledge and yielded acceptable proficiency in some echocardiographic findings commonly identified in the emergency room. This training course was not able to provide the skills needed for house officers to accurately assess fluid volume status, identify cardiac masses, ventricular enlargement or hypertrophy, and certain cardiac diseases.

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