title: Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study.
abstract: BACKGROUND
  Point-of-care (POC) echocardiography may be helpful for mass triage, but such a strategy requires adequately trained sonographers at the remote site. The aim of this study was to test the feasibility of using a novel POC echocardiography training program for improving physicians' imaging skills during preanesthetic cardiac evaluations performed in a community camp organized for treating cataract blindness.
  
  
  METHODS
  Seventeen physicians were provided 6 hours of training in the use of POC echocardiography; nine were taught on site and eight were taught online through a transcontinental tele-echocardiography system. The trained physicians subsequently scanned elderly patients undergoing cataract surgery. The quality of images was graded, and agreement between local physicians' interpretations and Web-based interpretations by worldwide experts was compared.
  
  
  RESULTS
  A total of 968 studies were performed, with 660 used for validating physicians' competence. Major cardiac abnormalities were seen in 136 patients (14.2%), with 32 (3.3%) deemed prohibitive to surgery in unmonitored settings. Although good-quality images were obtained more frequently by physicians trained on site rather than online (P = .03), there were no differences between the two groups in agreement with expert interpretations. The majority of physicians (70.6%) expressed satisfaction with the training (average Likert-type scale score, 4.24 of 5), with no difference seen between the two groups. The training resulted in significant improvements in self-perceived competence in all components of POC echocardiography (P < .001 for all).
  
  
  CONCLUSIONS
  This study establishes the feasibility of using short-duration, one-on-one, personalized transcontinental tele-echocardiography education for wider dissemination of echocardiographic skills to local physicians in remote communities, essential for optimizing global cardiovascular health.
authors.affiliation: Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Bansal
authors.affiliation: Shah Satnam Ji Specialty Hospital, Sirsa, Haryana, India.
authors.forename: Shaanemeet
authors.initials: S
authors.lastname: Singh
authors.affiliation: Shah Satnam Ji Specialty Hospital, Sirsa, Haryana, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Maheshwari
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: David
authors.initials: D
authors.lastname: Adams
authors.affiliation: Methodist DeBakey Heart & Vascular Centre, Houston, Texas.
authors.forename: Marti L
authors.initials: ML
authors.lastname: McCulloch
authors.affiliation: Shah Satnam Ji Specialty Hospital, Sirsa, Haryana, India.
authors.forename: Tanuj
authors.initials: T
authors.lastname: Dada
authors.affiliation: Sengupta Hospital and Research Center, Nagpur, Maharashtra, India.
authors.forename: Shantanu P
authors.initials: SP
authors.lastname: Sengupta
authors.affiliation: Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: Ravi R
authors.initials: RR
authors.lastname: Kasliwal
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pellikka
authors.affiliation: Mount Sinai Medical Center, New York, New York. Electronic address: partho.sengupta@mountsinai.org.
authors.forename: Partho P
authors.initials: PP
authors.lastname: Sengupta
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003194:Computer-Assisted Instruction / Q000379:methods / Q000706:statistics & numerical data*; D003479:Curriculum; D004521:Educational Measurement / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007194:India; D038622:Internationality; D008297:Male; D011871:Radiology / Q000193:education*; D019112:Teleradiology / Q000706:statistics & numerical data*; D014584:User-Computer Interface
keywords: Focused ultrasound; Tele-echocardiography; Tele-education