Objective
The use of basic transesophageal echocardiography (TEE) in critically ill and older
surgical patients can change patient management and improve outcomes after noncardiac
surgery. The authors hypothesized that educating the future generation on basic TEE
skills by an intense two-month rotation will help them achieve basic TEE certification
by the National Board of Echocardiography (NBE) and facilitate good use of their skills
for patient care during their practice.
Design
This is a descriptive report of graduating anesthesiology residents who completed
two months basic TEE rotation at the authors’ residency program between 2013 and 2019.
The authors report the clinical training goals, NBE testamur and certification status,
and a survey report on the use of basic TEE skills in their practice
Settings
University medical center.
Participants
Residents who completed two months basic TEE rotation during their Clinical Anesthesia
(CA)-3 year.
Interventions
None.
Measurements and Main Results
Of a total of 115 residents, 67 (58%) elected basic TEE rotation. The NBE basic TEE
certification and testamur status were achieved by 12 (21%) and 14 (24%) eligible
residents, respectively. Residents (n = 43) personally performed 73 ± 21 (mean ± standard
deviation) and reviewed 72 ± 28 (mean ± standard deviation basic TEE studies before
graduation. The survey indicated that 63.4% of residents trained in basic TEE did
not use their skills in their practice.
Conclusions
Two months’ basic TEE rotation was able to fulfill its educational goals (testamur
status and clinical training) but fell short on achieving NBE certification rate and
its ultimate impact on practice and patient care.
Key Words
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References
- Non-surgical assessment of cardiac function.Nature. 1971; 232: 335-336
- Peri-operative TOE – does it have an effect on surgical practice.J Br Soc Echocardiogr. 2006; 55: 7-8
- Perioperative use of transesophageal echocardiography by anesthesiologists: Impact in noncardiac surgery and in the intensive care unit.Can J Anaesth. 2002; 49: 287
- Basic perioperative transesophageal echocardiography examination: A consensus statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists.J Am Soc Echocardiogr. 2013; 26: 443-456
- Perioperative transesophageal echocardiography for non-cardiac surgery.Can J Anaesth. 2018; 65: 381-398
- Intraoperative hemodynamic monitoring during organ transplantation: What is new?.Curr Opin Organ Transplant. 2009; 14: 291-296
- Transesophageal echocardiography in orthotopic liver transplantation: A comprehensive intraoperative monitoring tool.Crit Ultrasound J. 2017; 9: 15
- Intraoperative monitoring with transesophageal echocardiography: Indications, risks, and training.Anesthesiol Clin. 2006; 24: 737-753
- Transesophageal echocardiography in anesthesia and intensive care. The diagnostic importance of transesophageal echocardiography [article in German].Anaesthesist. 1997; 46: 504-514
- Introductory experience in transesophageal echocardiography for anesthesiology residents.MedEdPORTAL. 2018; 14: 10666
- The use of TEE simulation in teaching basic echocardiography skills to senior anesthesiology residents.J Cardiothorac Vasc Anesth. 2013; 27: 670-675
- Resident performance in basic perioperative transesophageal echocardiography: Comparing 3 teaching methods in a randomized controlled trial.Medicine (Baltimore). 2019; 98: e17072
- Novel, multimodal approach for basic transesophageal echocardiographic teaching.J Cardiothorac Vasc Anesth. 2014; 28: 800-809
- Impact of simulator-based training in focused transesophageal echocardiography: A randomized controlled trial.Anesth Analg. 2017; 125: 1140-1148
- Standard setting for clinical performance of basic perioperative transesophageal echocardiography: Moving beyond the written test.Anesthesiology. 2017; 126: 718-728
National Board of Echocardiography. Application for certification. Basic perioperative transesophageal echocardiography (Basic PTEeXAM). Available at: https://www.echoboards.org/docs/BasicPTE_Cert_App-2021.pdf. Accessed July 6, 2021.
- ASE/SCA recommendations and guidelines for continuous quality improvement in perioperative echocardiography.Anesth Analg. 2006; 103: 1416-1425
Anesthesiology News. Are ACGME requirements failing our anesthesiology residents?. Available at: https://www.anesthesiologynews.com/Correspondence/Article/06-21/Are-ACGME-Requirements-Failing-Our-Anesthesiology-Residents-/63684. Accessed July 7, 2021.
- Use, training, and opinions about effectiveness of transesophageal echocardiography in adult liver transplantation among anesthesiologists in the United States.Semin Cardiothorac Vasc Anesth. 2018; 22: 137-145
- Transesophageal echocardiography utilization in high-volume liver transplantation centers in the United States.J Cardiothorac Vasc Anesth. 2008; 22: 811-813
- Modules for the technical skills section of the OSCE component of the American Board of Anesthesiology APPLIED examination.MedEdPORTAL. 2019; 15: 10820
- Diagnostic point-of-care ultrasound: Recommendations from an expert panel.J Cardiothorac Vasc Anesth. 2021; ([e-pub ahead of print])https://doi.org/10.1053/j.jvca.2021.04.016
Article info
Publication history
Published online: August 13, 2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- An Unsentimental Education: How Should We Be Teaching Perioperative Echocardiography?Journal of Cardiothoracic and Vascular AnesthesiaVol. 36Issue 1
- PreviewPerioperative transesophageal echocardiography has become a mainstay in the world of cardiac surgery as cardiac anesthesiologists have embraced their dual role as anesthesia providers and echocardiographers, working in concert with cardiac surgeons to deliver high-quality care, much of which is predicated upon transesophageal echocardiography (TEE) findings obtained during the perioperative period. Given the virtually universal adoption of intraoperative TEE during cardiac surgery and its role in patient care, there has been understandable interest in expanding the role of perioperative TEE in the noncardiac surgical area.
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