• Robina Matyal, Mario Montealegre-Gallegos, John D Mitchell, Han Kim, Remco Bergman, Katie M Hawthorne, David O'Halloran, Vanessa Wong, Phillip E Hess, and Feroze Mahmood.
• Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA;
• J. Cardiothorac. Vasc. Anesth. 2015 Dec 1; 29 (6): 1504-10.

ObjectiveTo investigate whether a transesophageal echocardiography (TEE) simulator with motion analysis can be used to impart proficiency in TEE in an integrated curriculum-based model.DesignA prospective cohort study.SettingA tertiary-care university hospital.ParticipantsTEE-naïve cardiology fellows.InterventionsParticipants underwent an 8-session multimodal TEE training program. Manual skills were assessed at the end of sessions 2 and 8 using motion analysis of the TEE simulator's probe. At the end of the course, participants performed an intraoperative TEE; their examinations were video captured, and a blinded investigator evaluated the total time and image transitions needed for each view. Results are reported as mean±standard deviation, or median (interquartile range) where appropriate.Measurements And Main ResultsEleven fellows completed the knowledge and kinematic portions of the study. Five participants were excluded from the evaluation in the clinical setting because of interim exposure to TEE or having participated in a TEE rotation after the training course. An increase of 12.95% in post-test knowledge scores was observed. From the start to the end of the course, there was a significant reduction (p<0.001 for all) in the number of probe. During clinical performance evaluation, trainees were able to obtain all the required echocardiographic views unassisted but required a longer time and had more probe transitions when compared with an expert.ConclusionA curriculum-based approach to TEE training for cardiology fellows can be complemented with kinematic analyses to objectify acquisition of manual skills during simulator-based training.Copyright © 2015 Elsevier Inc. All rights reserved.

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