title: Training Program for Cardiology Residents to Perform Focused Cardiac Ultrasound Examination with Portable Device.
abstract: BACKGROUND
  Training requirements for general cardiologists without echocardiographic expertise to perform focused cardiac ultrasound (FCU) with portable devices have not yet been defined. The objective of this study was to evaluate a training program to instruct cardiology residents to perform FCU with a hand-carried device (HCD) in different clinical settings.
  
  
  METHODS
  Twelve cardiology residents were subjected to a 50-question test, 4 lectures on basic echocardiography and imaging interpretation, the supervised interpretation of 50 echocardiograms and performance of 30 exams using HCD. After this period, they repeated the written test and were administered a practical test comprising 30 exams each (360 patients) in different clinical settings. They reported on 15 parameters and a final diagnosis; their findings were compared to the HCD exam of a specialist in echocardiography.
  
  
  RESULTS
  The proportion of correct answers on the theoretical test was higher after training (86%) than before (51%; P = 0.001). The agreement was substantial among the 15 parameters analyzed (kappa ranging from 0.615 to 0.891; P < 0.001). The percentage of correct interpretation was lower for abnormal (75%) than normal (95%) items, for valve abnormalities (85%) compared to other items (92%) and for graded scale (87%) than for dichotomous (95%) items (P < 0.0001, for all). For the final diagnoses, the kappa value was higher than 0.941 (P < 0.001; 95% CI [0.914, 0.955]).
  
  
  CONCLUSIONS
  The training proposed enabled residents to perform FCU with HCD, and their findings were in good agreement with those of a cardiologist specialized in echocardiography.
authors.affiliation: Cardiology Department, Paulista School of Medicine, Federal University of São Paulo, Brazil.
authors.forename: Vicente N
authors.initials: VN
authors.lastname: Siqueira
authors.affiliation: Cardiology Department, Paulista School of Medicine, Federal University of São Paulo, Brazil.
authors.forename: Frederico J N
authors.initials: FJ
authors.lastname: Mancuso
authors.affiliation: Cardiology Department, Paulista School of Medicine, Federal University of São Paulo, Brazil.
authors.forename: Orlando
authors.initials: O
authors.lastname: Campos
authors.affiliation: Cardiology Department, Paulista School of Medicine, Federal University of São Paulo, Brazil.
authors.forename: Angelo A
authors.initials: AA
authors.lastname: De Paola
authors.affiliation: Cardiology Department, Paulista School of Medicine, Federal University of São Paulo, Brazil.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Carvalho
authors.affiliation: Cardiology Department, Paulista School of Medicine, Federal University of São Paulo, Brazil.
authors.forename: Valdir A
authors.initials: VA
authors.lastname: Moises
mesh_terms: D002309:Cardiology / Q000193:education*; D002983:Clinical Competence; D003479:Curriculum; D004452:Echocardiography / Q000295:instrumentation* / Q000592:standards*; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D015397:Program Evaluation
keywords: cardiology residents; echocardiography; focused cardiac ultrasound; hand-carried ultrasound device