title: Point-of-care echocardiography in simulation-based education and assessment.
abstract: BACKGROUND
  Emergency medicine milestones released by the Accreditation Council for Graduate Medical Education require residents to demonstrate competency in bedside ultrasound (US). The acquisition of these skills necessitates a combination of exposure to clinical pathology, hands-on US training, and feedback.
  
  
  OBJECTIVE
  We describe a novel simulation-based educational and assessment tool designed to evaluate emergency medicine residents' competency in point-of-care echocardiography for evaluation of a hypotensive patient with chest pain using bedside US.
  
  
  METHODS
  This was a cross-sectional study conducted at an academic medical center. A simulation-based module was developed to teach and assess the use of point-of-care echocardiography in the evaluation of the hypotensive patient. The focus of this module was sonographic imaging of cardiac pathology, and this focus was incorporated in all components of the session: asynchronous learning, didactic lecture, case-based learning, and hands-on stations.
  
  
  RESULTS
  A total of 52 residents with varying US experience participated in this study. Questions focused on knowledge assessment demonstrated improvement across the postgraduate year (PGY) of training. Objective standardized clinical examination evaluation demonstrated improvement between PGY I and PGY III; however, it was noted that there was a small dip in hands-on scanning skills during the PGY II. Clinical diagnosis and management skills also demonstrated incremental improvement across the PGY of training.
  
  
  CONCLUSIONS
  The 1-day, simulation-based US workshop was an effective educational and assessment tool at our institution.
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Amini
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Stolz
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Parisa P
authors.initials: PP
authors.lastname: Javedani
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Gaskin
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Nicola
authors.initials: N
authors.lastname: Baker
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Ng
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Srikar
authors.initials: S
authors.lastname: Adhikari
keywords: point-of care ultrasound; simulation education