The Ideal Sequence of Didactic Lectures and Simulation in Teaching Transoesophageal Echocardiography (TEE) Among Anaesthesiologists

Basic Transoesophageal Echocardiography (TEE) is an essential skill in the armamentarium of an anaesthesiologist. Currently, majority of the TEE teaching is being done in the form of didactic lectures with only a few teaching centres offering simulation. TEE skill acquisition includes both technical and cognitive skills. Most of the studies done in TEE teaching have concluded that TEE simulation is an essential part of TEE skill training. The study team wanted to find out what is the best sequence of teaching to achieve the maximum skill acquisition in TEE.

In National University Hospital, Singapore, the Cardiac subdivision of anaesthesia specialists are accredited in TEE (American or European exams) and perform independent decision making in cardiac surgical theatres while the surgery is on-goingto facilitate dynamic decision making such as adequacy of valve repair, global LV function and emerging complications if any. The study team realised that TEE skills are also required for decisions beyond the cardiac surgical theaters where on the spot critical decisions making is required eg: in polytrauma and sudden unexplained hypotension or hypoxia in non-cardiac or ICU patients.

There are existing induction modules and prior teaching avenues in the department of anaesthesia such as the Cardiac Anaesthesia Simulation Training (CAST) module targeted at junior trainee's level. With initiative to equip every practicing anaesthesiologist with the vital skill of TEE image acquisition, the department of anaesthesia is launching a teaching program that is an in house training session. The study team aims to understand through this study the ideal sequence of teaching intervention to facilitate optimal learning and retention.