title: Effectiveness of a Perioperative Transthoracic Ultrasound Training Program for Students and Residents.
abstract: OBJECTIVE
  Focused ultrasound (US) is being incorporated across all levels of medical education. Although many comprehensive US courses exist, their scope is broad, requiring expert instructors, access to simulation, and extensive time commitment by the learner. We aim to compare learning across levels of training and specialties using a goal-directed, web-based course without live skills training.
  
  
  METHODS
  A prospective observational study of students and residents from medicine, surgery, and anesthesiology. Analysis compared pretests and posttests assessing 3 competencies. Individual mean score improvement (MSI) was compared by paired-sample t-tests and MSI among cohorts by analysis of variance, with significance set at p ≤ 0.05. McNemar test compared those who agreed or strongly agreed with survey items with those who did not before and after intervention.
  
  
  METHODS
  Jackson Memorial Hospital, Miami, FL residency training programs in Medicine, Surgery, and Anesthesiology.
  
  
  RESULTS
  A total of 180 trainees participated. A significant MSI was noted in each of 3 competencies in all 3 cohorts. Students' (S) MSI was significantly higher than residents' (R) and interns' (I) in US "knobology" and window recognition [S = 2.28 ± 1.29/5 vs R = 1.63 ± 1.21/5 (p = 0.014); vs I = 1.59 ± 1.12/5 (p = 0.032)]; students' total score MSI was significantly higher than residents [7.60 ± 3.43/20 vs 5.78 ± 3.08/20 (p < 0.008)]. All cohorts reported improved comfort in using transthoracic US and improved ability to recognize indications for use. More than 81% of all participants reported improved confidence in performing transthoracic US; more than 91% reported interest in additional training; and more than 88% believed course length was appropriate.
  
  
  CONCLUSIONS
  Learners across levels of medical training and specialties can benefit from a brief, goal-directed, web-based training with early incorporation producing maximal yield.
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: jray@med.miami.edu.
authors.forename: Juliet June
authors.initials: JJ
authors.lastname: Ray
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Meizoso
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Valerie
authors.initials: V
authors.lastname: Hart
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Davis
authors.initials: D
authors.lastname: Horkan
authors.affiliation: Department of Anesthesiology, Florida International University, Miami, Florida.
authors.forename: Vicente
authors.initials: V
authors.lastname: Behrens
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Krishnamurti A
authors.initials: KA
authors.lastname: Rao
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Karcutskie
authors.affiliation: Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami Miller School of Medicine, Miami, Florida; Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Joshua
authors.initials: J
authors.lastname: Lenchus
authors.affiliation: DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
authors.affiliation: Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Roman
authors.initials: R
authors.lastname: Dudaryk
mesh_terms: D000776:Anesthesiology / Q000193:education; D002983:Clinical Competence; D015510:Clinical Medicine / Q000193:education; D015331:Cohort Studies; D004452:Echocardiography; D004503:Education, Medical, Graduate / Q000379:methods*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008297:Male; D019990:Perioperative Care; D010865:Pilot Projects; D011446:Prospective Studies; D013337:Students, Medical / Q000706:statistics & numerical data; D014481:United States
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; course; education; focus assessed transthoracic echocardiography; sonography; ultrasound