• Gwénaël Prat, Cyril Charron, Xavier Repesse, Pierre Coriat, Pierre Bailly, Erwan L'her, and Antoine Vieillard-Baron.
• Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609, Brest Cedex, France. gwenael.prat@chu-brest.fr.
• Ann Intensive Care. 2016 Dec 1; 6 (1): 27.

BackgroundOur aim was to evaluate the impact of a computerized echocardiographic simulator on the learning curve for transesophageal echocardiography (TEE) hemodynamic assessment of ventilated patients in the ICU.MethodsWe performed a prospective study in two university hospital medical ICUs. Using our previously validated skill assessment scoring system (/40 points), we compared learning curves obtained with (interventional group, n = 25 trainees) and without (control group, n = 31 trainees) use of a simulator in the training. Three evaluations were performed after 1 (M1), 3 (M3) and 6 months (M6) while performing two TEE examinations graded by an expert. Competency was defined as a score >35/40.ResultsCompetency was achieved after an average of 32.5 ± 10 supervised studies in the control group compared with only 13.6 ± 8.5 in the interventional group (p < 0.0001). At M6, a significant between-group difference in number of supervised TEE was observed (17 [14-28] in the control group vs. 30.5 [21.5-39.5] in the interventional group, p = 0.001). The score was significantly higher in the interventional group at M1 (32.5 [29.25-35.5] vs. 24.75 [20-30.25]; p = 0.0001), M3 (37 [33.5-38.5] vs. 32 [30.37-34.5]; p = 0.0004), but not at M6 (37.5 [33-39] vs. 36 [33.5-37.5] p = 0.24).ConclusionInclusion of echocardiographic simulator sessions in a standardized curriculum may improve the learning curve for hemodynamic evaluation of ventilated ICU patients.

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