Focused Cardiac and Lung Ultrasound in Anesthesia/Critical Care - The Role of Self-directed Simulation-assisted Training Compared to a Traditional Supervised Approach

Not Applicable

• Conditions: Education, Medical; Critical Care Ultrasonography
• Interventions: Other: Self-directed and simulation-assisted training; Other: Traditional apprenticeship training

• Registration Number: NCT01972698
• Lead Sponsor: Unity Health Toronto

Brief Summary

The purpose of this study is to determine whether a self-directed and simulation-based lung ultrasound (LUS) and focused cardiac ultrasound (FCU) curriculum is efficacious on anesthesia trainees' image acquisition skills and diagnostic acumen. The investigators hypothesize that a self-directed and ultrasound-assisted LUS and FCU curriculum that includes video lectures, online teaching modules, an ultrasound simulator, and self-directed hands-on sessions on critically ill mechanically ventilated patients is effective in training novice ultrasonographers to obtain good quality images, to correctly interpret them, and to support clinical decision-making in critically ill patients.

Trainees will be randomized to fully supervised FCU hands-on sessions on healthy models and critically ill mechanically ventilated patients (control group - traditional apprenticeship model) or to a completely self-directed and simulation-based approach (intervention group).

To assess if this new self-directed and simulation-based ultrasound curriculum leads to adequate acquisition of competences (adequate image acquisition and interpretation) in novice ultrasonographers, trainees will have to perform a focused lung and cardiac assessment on a critically ill mechanically ventilated patient.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2013-10-24
• Study First Submitted QC: 2013-10-29
• Study First Posted: 2013-10-30
• Study Start: 2014-11
• Status Verified: 2016-12
• Last Update Submitted: 2016-12-05
• Last Update Posted: 2016-12-06
• Primary Completion: 2018-06
• Study Completion: 2018-06

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• PGY1 and PGY2 anesthesia resident at the University of Toronto

Exclusion Criteria

• Previous training in lung ultrasound or FCU

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Self-directed and simulation-assisted training	Self-directed and simulation-assisted training	-
Traditional apprenticeship training	Traditional apprenticeship training	-

Primary Outcome Measures

Name	Time	Method
Difference between pre- and post-intervention image acquisition and interpretation skill (as compared to the benchmark exam).	~4-5 months post-study enrolment, after completion of ultrasound training	The quality of the images will be scored from 1 (worst) to 5 (best). The score will be based on the assessment of the quality of the image as well as an assessment of relevant cardiac structures included in each view.; Difference between pre- and post-intervention image acquisition skills and knowledge as measured by: * Scanning time (total and per view); * Anatomy recognition; * Items completion (%); * Image interpretation (Y/N for lung sliding, interstitial syndrome, pleural effusion, consolidation, pericardial fluid, LV global function, RV global function, intravascular volume assessment; total and per objective accuracy); * MCQs results (%) (Indication \& Image interpretation assessment); * Video-interpretation of cases results (%) (Image interpretation \& Clinical decision-making assessment); * Qualitative and quantitative analysis of survey results (dichotomic questions; graded criteria; e.g.10-point Likert scale)

Secondary Outcome Measures

Name	Time	Method
Differences between self-directed and simulation-assisted training and traditional apprenticeship training	~4-5 months post-study enrolment, after completion of ultrasound training	Difference between groups in image acquisition skills and knowledge as measured by: * Quality of images obtained (total and per view score); * Scanning time (total and per view); * Anatomy recognition (at least 4 structures identified/views for FCU, and 3 structures identified/LUS findings for LUS; max score 20 + 6); * Items completion (%); * Image interpretation (Y/N for lung sliding, interstitial syndrome, pleural effusion, consolidation, pericardial fluid, LV global function, RV global function, intravascular volume assessment; total and per objective accuracy); * MCQs results (%) (Indication \& Image interpretation assessment); * Video-interpretation of cases results (%) (Image interpretation \& Clinical decision-making assessment); * Qualitative and quantitative analysis of survey results (dichotomic questions; graded criteria; e.g.10-point Likert scale)

Trial Locations

Locations (1)

St. Michael's Hospital; 🇨🇦 Toronto, Ontario, Canada