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Annals of intensive care · Jan 2014
Prospective assessment of a score for assessing basic critical-care transthoracic echocardiography skills in ventilated critically ill patients.
- Mathieu Jozwiak, Xavier Monnet, Raphaël Cinotti, Fréderic Bontemps, Jean Reignier, and Guillaume Belliard.
- Centre Hospitalier Départemental de la Vendée, service de réanimation, La Roche-sur-Yon F-85000, France.
- Ann Intensive Care. 2014 Jan 1; 4: 12.
BackgroundWe studied a score for assessing basic transthoracic echocardiography (TTE) skills exhibited by residents who examined critically ill patients receiving mechanical ventilation.MethodsWe conducted a prospective study in the 16 residents who worked in our medical-surgical ICU between 1 May 2008 and 1 November 2009. The residents received theoretical teaching (two hours) then performed supervised TTEs during their six-month rotation. Their basic TTE skills in mechanically ventilated patients were evaluated after one (M1), three (M3), and six (M6) months by two experts, who used a scoring system devised for the study. After scoring, residents gave their hemodynamic diagnosis and suggested a treatment.ResultsThe 4 residents with previous TTE skills obtained a significantly higher total score than did the 12 novices at M1 (18 (16 to 19) versus 13 (10 to 15), respectively, P = 0.03). In the novices, the total score increased significantly during training (M1, 13 (10 to 14); M3, 15 (12 to 16); and M6, 17 (15 to 18); P < 0.001) and correlated significantly with the number of supervised TTEs (r = 0.68, P < 0.0001). In the overall population, agreement with experts regarding the diagnosis and treatment was associated with a significantly higher total score (17 (16 to 18) versus 13 (12 to 16), P = 0.002). A total score ≥ 19/20 points had 100% specificity (95% confidence interval, 79 to 100%) for full agreement with the experts regarding the diagnosis and treatment.ConclusionsOur results validate the scoring system developed for our study of the assessment of basic critical-care TTE skills in residents.
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