title: Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners.
abstract: BACKGROUND
  Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation.
  
  
  METHODS
  Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed.
  
  
  RESULTS
  At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9).
  
  
  CONCLUSIONS
  Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.
authors.affiliation: Department of Anesthesiology and Intensive care, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark. caf@ki.au.dk
authors.forename: Christian Alcaraz
authors.initials: CA
authors.lastname: Frederiksen
authors.forename: Peter
authors.initials: P
authors.lastname: Juhl-Olsen
authors.forename: Dorte Guldbrand
authors.initials: DG
authors.lastname: Nielsen
authors.forename: Berit
authors.initials: B
authors.lastname: Eika
authors.forename: Erik
authors.initials: E
authors.lastname: Sloth
mesh_terms: D000328:Adult; D002309:Cardiology / Q000193:education*; D002983:Clinical Competence; D003479:Curriculum; D003718:Denmark; D004452:Echocardiography; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D017145:Models, Educational; D019095:Point-of-Care Systems