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///2018 Abstract Details
2018 Abstract Details2019-08-02T15:57:01-05:00

Knowledge Retention in Transthoracic Echocardiography by Obstetric Anesthesiologists Following a Focused Cardiac Ultrasound Workshop

Abstract Number: S4A-2
Abstract Type: Original Research

Janette Brohan MB BCh BAO FCAI FJFICMI1 ; James Taylor BSc2; Anna West MBBS3; Arianne Albert PhD4; Anthony Chau MD FRCPC MMSc5

Introduction: Focused cardiac ultrasound (FOCUS) involves abbreviated transthoracic echocardiography (TTE) to identify potentially significant hemodynamic or structural cardiac abnormalities.[1] The potential role of FOCUS in the obstetric setting has been recognized;[2] however, few obstetric anesthesiologists have been trained. We developed a FOCUS workshop for obstetric anesthesiologists in our department who were TTE novices. The purpose of this study was to determine knowledge retention 6 months post-workshop.

Methods: Following a literature review, a 3-hour FOCUS workshop (pre-workshop reading, a multiple choice questionnaire (MCQ), didactic lectures with image interpretation cases, and hands-on skill stations) was developed and reviewed by 2 instructors trained in TTE. After obtaining University accreditation and an IRB waiver of consent, 8 obstetric anesthesiologist TTE novices were invited to attend the FOCUS workshop (FOCUS group). FOCUS group participants read pre-workshop materials and completed a MCQ at time=0 (immediately post-workshop) and at 3 and 6 months. The same MCQ questions were used, but randomized before each administration. 8 physician TTE novices who did not attend the workshop (control group) also completed the MCQ. The primary outcome was mean scores at 6 months post-workshop in the FOCUS group analyzed by independent samples T-test. The secondary outcome was the change in scores over time for the FOCUS group analyzed using mixed-effects regression.

Results: At 6-months, the mean scores of the FOCUS group remained significantly higher compared to the control group (79.4% vs. 56.3%, p=0.002). One participant experienced a significant reduction in test score of 35% from time=0 to 6-months.There was a significant overall effect of time, controlling for repeated measures (likelihood ratio test p=0.02). Post-hoc pairwise Tukey’s tests suggest that the only significant difference occurred between scores at time=0 and at 6 months (94.7% vs. 79.4%, p=0.03). (Fig 1)

Discussion: We demonstrated that a 3-hour FOCUS workshop can help obstetric anesthesiologist TTE novices rapidly acquire basic TTE knowledge that was retained for at least 3 months. At 6 months, there was a significant decline in the mean score below 80%, suggesting that repeating this quality improvement initiative every 6 months may be helpful in sustaining knowledge retention.

References:

1 Spencer K et al. J Am Soc Echocardiogr 2013

2 Dennis A et al. Anesth Analg 2012



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