Short summary

This study evaluates the basic skills in focused cardiac ultrasound (FoCUS) using a simulator to establish a validated test before clinical application. Thirty-six participants at different experience levels, including novices, intermediates, and experienced physicians, will be assessed through simulation-based training. Data collection includes participant characteristics and test performance on ultrasound image acquisition and interpretation. The study aims to develop a standardized competency

Rationale

Cardiac ultrasound is an important diagnostic adjunct in the emergency setting. Especially in patients presenting with dyspnoea or chest pain; unspecific symptoms observed in several conditions discernible by means of ultrasound, encompassing acute coronary syndrome, heart failure, pulmonary embolism, acute valve pathology or pericardial effusion. Historically, cardiologists were responsible for performing and interpreting practically all cardiac ultrasound investigations. However, as acknowledged by the European Association of Cardiovascular Imaging (EACVI), a range of medical specialties has integrated its use in daily clinical practice. For instance, anaesthesiologists, pulmonologists, and emergency physicians. Fields in which acute cardiovascular symptoms and complications are common and where ultrasonographic examination of the heart should be conducted to avoid delay in diagnosis. In these scenarios, a comprehensive assessment of cardiac function and morphology through a full echocardiographic examination is seldom necessary. Rather, in most emergency situations, a focused assessment of only a few selected pre-specified cardiac abnormalities may aid in narrowing differential diagnostic considerations, initiate therapy, or lead to further diagnostic work-up.

Description of the cohort

The cohort in this study consists of 36 participants with varying levels of experience in focused cardiac ultrasound (FoCUS). The participants are divided into three groups based on their expertise. The novice group includes final-year medical students or junior doctors with less than six months of experience who have completed a one-hour lecture and a two-hour hands-on course on FoCUS as part of their medical education at the University of Southern Denmark and have performed fewer than five FoCUS examinations. The intermediate group consists of physicians employed in introductory positions within specialties that utilize FoCUS, such as emergency medicine, cardiology, pulmonology, and anesthesiology, who have performed between five and fifty FoCUS examinations. The experienced group comprises physicians from the same specialties who have completed their introductory training or are at the registrar or consultant level and have performed more than one hundred FoCUS examinations. The study takes place at Svendborg Hospital and Odense University Hospital in Denmark, utilizing a medical ultrasound simulator (U/S Mentor from Simbionix) to assess the participants' competencies in FoCUS.

Data and biological material

The study does not involve the collection of biological material such as blood samples, feces, urine, or saliva. The data collected includes demographic information, participant characteristics, and performance metrics related to focused cardiac ultrasound (FoCUS). Participants will complete a questionnaire covering aspects such as age, years as a medical doctor, current appointment and specialty, years in the specialty, total number of FoCUS and FLUS examinations performed, other ultrasound experience, and any ultrasound courses or certifications obtained. Additionally, test performance data will be gathered from the ultrasound simulator, assessing participants' ability to acquire and interpret cardiac ultrasound images. No data will be collected from patient journals or national registries. All data will be anonymized and securely stored in a REDCap database administered by Open Patient Exploratory Network (OPEN).

Collaborating researchers and departments

Department of Internal Medicine, Odense University Hospital Svendborg, Denmark

• Casper Falster

Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Denmark

• Casper Falster

Department of Cardiology, Odense University Hospital, Denmark

• Gro Egholm

Department of Emergency Medicine, Odense University Hospital, Denmark

• Stefan Posth

SimC - Simulation Centre, Odense University Hospital, Denmark

• Siw Nielsen
• Anders Bo Nielsen

Cardiovascular Research Unit, Odense University Hospital Svendborg, Denmark.

• Jess Lambrechtsen

Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark

• Jess Lambrechtsen

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark

• Lars Konge

Copenhagen Academy for Medical Education and Simulation (CAMES), Denmark

• Lars Konge