Canadian guidelines for training in adult perioperative transesophageal echocardiography. Recommendations of the Cardiovascular Section of the Canadian Anesthesiologists' Society and the Canadian Society of Echocardiography.
OBJECTIVE
To establish Canadian guidelines for training in adult perioperative transesophageal echocardiography (TEE).


METHODS
Guidelines were established by the Canadian Perioperative Echocardiography Group with the support of the cardiovascular section of the Canadian Anesthesiologists' Society (CAS) in conjunction with the Canadian Society of Echocardiography. Guidelines for training in echocardiography by the American Society of Echocardiography, the American College of Cardiology and the Society of Cardiovascular Anesthesiologists were reviewed, modified and expanded to produce the 2003 Quebec expert consensus for training in perioperative echocardiography. The Quebec expert consensus and the 2005 Guidelines for the provision of echocardiography in Canada formed the basis of the Canadian training guidelines in adult perioperative TEE.


RESULTS
Basic, advanced and director levels of expertise were identified. The total number of echocardiographic examinations to achieve each level of expertise remains unchanged from the 2002 American Society of Echocardiography-Society of Cardiovascular Anesthesiologists guidelines. The increased proportion of examinations personally performed at basic and advanced levels, and the level of autonomy at the basic level suggested by the Quebec expert consensus are retained. These examinations can be performed in a perioperative setting and are not limited to intraoperative TEE. Training "on the job", the role of the perioperative transesophageal echocardiography examination, requirements for maintenance of competence, and duration of training are also discussed for each level of training. The components of a TEE report and comprehensive TEE examination are also outlined.


CONCLUSIONS
The Canadian guidelines for training in adult perioperative TEE reflect the unique Canadian practice profile in perioperative TEE and address the training requirements to obtain expertise in this field.
Béïque
François
F
SMBD Jewish General Hospital, 3755 chemin de la Côte Ste-Catherine, Montreal, Quebec H3T 1E2, Canada. fbeique@ana.jgh.mcgill.ca
Ali
Mohamed
M
Hynes
Mark
M
MacKenzie
Scott
S
Denault
André
A
Martineau
André
A
MacAdams
Charles
C
Sawchuk
Corey
C
Hirsch
Kristine
K
Lampa
Martin
M
Murphy
Patricia
P
Honos
Georges
G
Munt
Bradley
B
Sanfilippo
Anthony
A
Duke
Peter
P
D000328:Adult; D000776:Anesthesiology / Q000193:education*; D002170:Canada; D002309:Cardiology / Q000193:education*; D002983:Clinical Competence; D017548:Echocardiography, Transesophageal; D004502:Education, Medical, Continuing; D006801:Humans; D019990:Perioperative Care