title: Anesthesiologists' learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study.
abstract: OBJECTIVE
  Focused assessment of the gastric antrum by ultrasound is a feasible tool to evaluate the quality of the stomach content. We aimed to determine the amount of training an anesthesiologist would need to achieve competence in the bedside ultrasound technique for qualitative assessment of gastric content.
  
  
  METHODS
  Six anesthesiologists underwent a teaching intervention followed by a formative assessment; then learning curves were constructed. Participants received didactic teaching (reading material, picture library, and lecture) and an interactive hands-on workshop on live models directed by an expert sonographer. The participants were instructed on how to perform a systematic qualitative assessment to diagnose one of three distinct categories of gastric content (empty, clear fluid, solid) in healthy volunteers. Individual learning curves were constructed using the cumulative sum method, and competence was defined as a 90% success rate in a series of ultrasound examinations. A predictive model was further developed based on the entire cohort performance to determine the number of cases required to achieve a 95% success rate.
  
  
  RESULTS
  Each anesthesiologist performed 30 ultrasound examinations (a total of 180 assessments), and three of the six participants achieved competence. The average number of cases required to achieve 90% and 95% success rates was estimated to be 24 and 33, respectively.
  
  
  CONCLUSIONS
  With appropriate training and supervision, it is estimated that anesthesiologists will achieve a 95% success rate in bedside qualitative ultrasound assessment after performing approximately 33 examinations.
authors.affiliation: Department of Anesthesia and Pain Management, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Room 19-104, Toronto, ON, M5G 1X5, Canada. carzola@mtsinai.on.ca
authors.forename: Cristian
authors.initials: C
authors.lastname: Arzola
authors.forename: Jose C A
authors.initials: JC
authors.lastname: Carvalho
authors.forename: Javier
authors.initials: J
authors.lastname: Cubillos
authors.forename: Xiang Y
authors.initials: XY
authors.lastname: Ye
authors.forename: Anahi
authors.initials: A
authors.lastname: Perlas
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000193:education*; D001296:Audiovisual Aids; D002983:Clinical Competence; D015331:Cohort Studies; D004326:Drinking; D004435:Eating; D004521:Educational Measurement / Q000379:methods; D005215:Fasting; D005246:Feedback; D005766:Gastrointestinal Contents; D006801:Humans; D007858:Learning; D008297:Male; D017145:Models, Educational; D056888:Patient Positioning; D019095:Point-of-Care Systems; D011706:Pyloric Antrum / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013663:Teaching / Q000379:methods; D014463:Ultrasonography