• J Emerg Med · Dec 2023

    Randomized Controlled Trial

    Structured Cardiac Assessment Outperforms Visual Estimation in Novice Ultrasound Users: A Randomized Controlled Trial.

    • Alexei Berdnikov, Idan Roifman, Evan Tang, Osama Muhtaseb, and Jordan Chenkin.
    • Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Emergency Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
    • J Emerg Med. 2023 Dec 1; 65 (6): e563e567e563-e567.

    BackgroundTwo evidence-based techniques to determine left ventricular (LV) systolic function are taught in emergency medicine curricula. The first is a "structured approach," which qualitatively evaluates LV fractional shortening, E-point septal separation, and LV diameter. The other is the "eyeball method," which qualitatively estimates the LV ejection fraction (LVEF).ObjectiveThe aim of this study was to determine whether the structured approach or the eyeball method was superior for teaching LVEF estimation to novices.MethodsMedical students were recruited to participate in our randomized controlled trial. Participants were randomized to the structured approach group or eyeball method group and completed one of two 15-min educational modules. Participants subsequently interpreted 12 echocardiogram clips to determine LV function. The primary outcome was the percentage of correct interpretations as determined by a cardiologist.ResultsSeventy-four participants were invited to participate and 32 completed the study (15 in the structured approach and 17 in the eyeball method groups). The majority (30 of 32 [93.75%]) were first- and second-year medical students with no prior ultrasound training. The mean time to complete the training was similar between groups (16.8 vs. 17.8 min; p = 0.66). The primary outcome of percent of correct interpretations was significantly higher in the structured approach group compared with the eyeball method group (88.9% vs. 73.0%; p < 0.01).ConclusionsTraining novice ultrasound users in a structured qualitative LV assessment method was more effective than the eyeball method. Learners were able to achieve high accuracy after a brief training intervention. These results may help inform best practices for undergraduate ultrasound curriculum development.Copyright © 2023. Published by Elsevier Inc.

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