Hospitalist performance of cardiac hand-carried ultrasound after focused training.
OBJECTIVE
Because the training that noncardiologists require to perform cardiac hand-carried ultrasound has not been defined, we studied how well hospitalists perform hand-carried echocardiography after limited training.


METHODS
Ten hospitalists completed a focused training program that included performing an average of 35 hand-carried echocardiograms. Hospitalists' echocardiograms were compared with gold-standard conventional echocardiograms, and hospitalists were compared with 5 certified echocardiography technicians in their ability to acquire, measure, and interpret hand-carried ultrasound images and with 6 senior cardiology fellows in their ability to interpret echocardiograms.


RESULTS
Echocardiography technicians had significantly higher performance scores for image acquisition, measurement, and interpretation than hospitalists. Senior cardiology fellows outperformed hospitalists in most aspects of image interpretation. For hospitalists, learning image acquisition was more difficult than image interpretation.


CONCLUSIONS
Hospitalists can learn aspects of hand-carried echocardiography, but after 35 training echocardiograms cannot replicate the quality of conventional echocardiography. Whether the lower performance skills are important will depend on the clinical context of hand-carried echocardiography performed by hospitalists.
Martin
L David
LD
Department of Medicine, Johns Hopkins University, School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, Md 21224, USA.
Howell
Eric E
EE
Ziegelstein
Roy C
RC
Martire
Carol
C
Shapiro
Edward P
EP
Hellmann
David B
DB
D000488:Allied Health Personnel; D002983:Clinical Competence; D004452:Echocardiography / Q000295:instrumentation*; D004502:Education, Medical, Continuing; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D020445:Hospitalists / Q000193:education* / Q000592:standards*; D019095:Point-of-Care Systems; D014463:Ultrasonography / Q000295:instrumentation*