• Julian S Bick, Samuel Demaria, Jason D Kennedy, Andrew D Schwartz, Menachem M Weiner, Adam I Levine, Yaping Shi, Jonathan S Schildcrout, and Chad E Wagner.
• From the Department of Anesthesiology (J.S.B., J.S.S.), and Department of Biostatistics (Y.S., J.S.S.), School of Medicine, Vanderbilt University; and Department of Anesthesiology (J.D.K., C.E.W.), Vanderbilt University Medical Center Nashville, TN; Department of Anesthesiology (S.D.M., A.D.S., M.M.W., A.I.L.), Icahn School of Medicine at Mount Sinai, New York, NY.
• Simul Healthc. 2013 Oct 1;8(5):329-34.

IntroductionTraining in transesophageal echocardiography (TEE) requires a significant commitment of time and resources on behalf of the trainees and the instructors. Training opportunities may be limited in the busy clinical environment. Medical simulation has emerged as a complementary means by which to develop clinical skills. Transesophageal echocardiography simulators have been commercially available for several years, yet their ability to distinguish experts from novices has not been demonstrated. We used a standardized assessment tool to distinguish experts from novices using a commercially available TEE simulator.MethodsAnesthesiologists certified in advanced perioperative TEE and anesthesiology resident physicians were recruited into the expert and novice cohorts, respectively. The cohorts were recruited from 2 academic medical centers. The novice cohort received a structured introduction to the basic TEE examination. Both cohorts then proceeded to perform a basic TEE examination involving normal cardiac anatomy, which was evaluated by blinded raters using a standardized assessment tool.ResultsThe expert cohort consistently demonstrated the ability to obtain standard TEE imaging views in less time and more accurately than the novice cohort during the course of a simulated TEE examination.ConclusionsA simulated transesophageal examination of normal cardiac anatomy in concert with a standardized assessment tool permits ample discrimination between expert and novice echocardiographers as defined for this investigation. Future research will examine in detail the role echocardiography simulators should play during echocardiography training including assessment of training level.

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