Assessment of Perioperative Ultrasound Workflow Understanding: A Consensus.
OBJECTIVE
Understanding of the workflow of perioperative ultrasound (US) examination is an integral component of proficiency. Workflow consists of the practical steps prior to executing an US examination (eg, equipment operation). Whereas other proficiency components (ie, cognitive knowledge and manual dexterity) can be tested, workflow understanding is difficult to define and assess due to its contextual and institution-specific nature. The objective was to define the workflow components of specific perioperative US applications using an iterative process to reach a consensus opinion.


METHODS
Expert consensus, survey study.


METHODS
Tertiary university hospital.


METHODS
This study sought expert consensus among a focus group of 9 members of an anesthesia department with experience in perioperative US. Afterward, 257 anesthesia faculty members from 133 academic centers across the United States were surveyed.


METHODS
A preliminary list of tasks was designed to establish the expectations of workflow understanding by an anesthesiology resident prior to clinical exposure to perioperative US. This list was modified by a focus group through an iterative process. Afterwards, a survey was sent to faculty members nationwide, and Likert scale ratings for each task were obtained and reviewed during a second round.


RESULTS
Consensus among members of the focus group was reached after 2 iterations. 72 participants responded to the nationwide survey (28%), and consensus was reached after the second round (Cronbach's α = 0.99, ICC = 0.99) on a final list of 46 workflow-related tasks.


CONCLUSIONS
Specific components of perioperative US workflow were identified. Evaluation of workflow understanding may be combined with cognitive knowledge and manual dexterity testing for assessing proficiency in perioperative US.
Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Lu
L
Yeh
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Mario
M
Montealegre-Gallegos
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: fmahmood@bidmc.harvard.edu.
Feroze
F
Mahmood
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Philip E
PE
Hess
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Marc
M
Shnider
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
John D
JD
Mitchell
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Stephanie B
SB
Jones
Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
Azad
A
Mashari
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Vanessa
V
Wong
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Robina
R
Matyal
D000776:Anesthesiology / Q000193:education / Q000458:organization & administration* / Q000592:standards; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods; D017144:Focus Groups; D006801:Humans; D019990:Perioperative Care / Q000379:methods / Q000592:standards*; D013647:Task Performance and Analysis; D014463:Ultrasonography / Q000592:standards*; D014481:United States; D057188:Workflow
anesthesia education; perioperative ultrasound; proficiency; workflow