TY - JOUR
T1 - Criteria, Processes, and Determination of Competence in Basic Critical Care Echocardiography Training
T2 - A Delphi Process Consensus Statement by the Learning Ultrasound in Critical Care (LUCC) Initiative
AU - Rajamani, Arvind
AU - Galarza, Laura
AU - Sanfilippo, Filippo
AU - Wong, Adrian
AU - Goffi, Alberto
AU - Tuinman, Pieter
AU - Mayo, Paul
AU - Arntfield, Robert
AU - Fisher, Richard
AU - Chew, Michelle
AU - Slama, Michel
AU - Mackenzie, David
AU - Ho, Eunise
AU - Smith, Louise
AU - Renner, Markus
AU - Tavares, Miguel
AU - Prabu R., Natesh
AU - Ramanathan, Kollengode
AU - Knudsen, Sebastian
AU - Bhat, Vijeth
AU - SPARTAN Collaborative (Small Projects, Audits and Research Projects-Australia/New Zealand)
AU - Arvind, Hemamalini
AU - Huang, Stephen
N1 - Funding Information: Author contributions: A. R. is the author guarantor for the manuscript and takes responsibility for the scientific integrity of the manuscript. A. R. affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. A. R. wrote the first draft of the paper; A.R. R.F. and M. C. were responsible for the literature search; A.R. A.W. V.B. and S.H. designed the study; A.R. V.B. and S.H. designed questionnaires; A. R. L. G. F. S. A. W. A. G. P. T. P. M. R. A. R. F. M. C. M. S. D. M. E. H. L. S. M. R. M. T. N. R. P. K. R. S. K. V. B. and S. H. responded to questionnaires and finalized recommendations; A. R. and S. H. analyzed the de-identified results; L. G. collated the final results; A. W. choose the expert panel; A. G. created Figure 1; R. A. was responsible for the section on remote supervision; L. S. offered expert opinion on technical aspects of sonography; H. A. was responsible for collating and identifying responses; and S. H. analyzed the deidentified results. All authors wrote subsequent drafts of the manuscript. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: A. W. has previously received honorarium from GE for delivery of educational material. None declared: (A. R. L. G. F. S. A. G. P. T. P. M. R. A. R. F. M. C. M. S. D. M. E. H. L. S. M. R. M. T. N. R. P. K. R. S. K. V. B. H. A. S. H.). Additional information: The e-Appendixes, e-Figure, and e-Tables can be found in the Supplemental Materials section of the online article. FUNDING/SUPPORT:The authors have reported to CHEST that no funding was received for this study. Publisher Copyright: © 2021 American College of Chest Physicians
PY - 2022/2
Y1 - 2022/2
N2 - Background: With the paucity of high-quality studies on longitudinal basic critical care echocardiography (BCCE) training, expert opinion guidelines have guided BCCE competence educational standards and processes. However, existing guidelines lack precise detail due to methodological flaws during guideline development. Research Questions: To formulate methodologically robust guidelines on BCCE training using evidence and expert opinion, detailing specific criteria for every step, we conducted a modified Delphi process using the principles of the validated AGREE-II tool. Based on systematic reviews, the following domains were chosen: components of a longitudinal BCCE curriculum; pass-grade criteria for image-acquisition and image-interpretation; and formative/summative assessment and final competence processes. Study Design and Methods: Between April 2020 and May 2021, a total of 21 BCCE experts participated in four rounds. Rounds 1 and 2 used five web-based questionnaires, including branching-logic software for directed questions to individual panelists. In round 3 (videoconference), the panel finalized the recommendations by vote. During the journal peer-review process, Round 4 was conducted as Web-based questionnaires. Following each round, the agreement threshold for each item was determined as ≥ 80% for item inclusion and ≤ 30% for item exclusion. Results: Following rounds 1 and 2, agreement was reached on 62 of 114 items. To the 49 unresolved items, 12 additional items were added in round 3, with 56 reaching agreement and five items remaining unresolved. There was agreement that longitudinal BCCE training must include introductory training, mentored formative training, summative assessment for competence, and final cognitive assessment. Items requiring multiple rounds included two-dimensional views, Doppler, cardiac output, M-mode measurement, minimum scan numbers, and pass-grade criteria. Regarding objective criteria for image-acquisition and image-interpretation quality, the panel agreed on maintaining the same criteria for formative and summative assessment, to categorize BCCE findings as major vs minor and a standardized approach to errors, criteria for readiness for summative assessment, and supervisory options. Interpretation: In conclusion, this expert consensus statement presents comprehensive evidence-based recommendations on longitudinal BCCE training. However, these recommendations require prospective validation.
AB - Background: With the paucity of high-quality studies on longitudinal basic critical care echocardiography (BCCE) training, expert opinion guidelines have guided BCCE competence educational standards and processes. However, existing guidelines lack precise detail due to methodological flaws during guideline development. Research Questions: To formulate methodologically robust guidelines on BCCE training using evidence and expert opinion, detailing specific criteria for every step, we conducted a modified Delphi process using the principles of the validated AGREE-II tool. Based on systematic reviews, the following domains were chosen: components of a longitudinal BCCE curriculum; pass-grade criteria for image-acquisition and image-interpretation; and formative/summative assessment and final competence processes. Study Design and Methods: Between April 2020 and May 2021, a total of 21 BCCE experts participated in four rounds. Rounds 1 and 2 used five web-based questionnaires, including branching-logic software for directed questions to individual panelists. In round 3 (videoconference), the panel finalized the recommendations by vote. During the journal peer-review process, Round 4 was conducted as Web-based questionnaires. Following each round, the agreement threshold for each item was determined as ≥ 80% for item inclusion and ≤ 30% for item exclusion. Results: Following rounds 1 and 2, agreement was reached on 62 of 114 items. To the 49 unresolved items, 12 additional items were added in round 3, with 56 reaching agreement and five items remaining unresolved. There was agreement that longitudinal BCCE training must include introductory training, mentored formative training, summative assessment for competence, and final cognitive assessment. Items requiring multiple rounds included two-dimensional views, Doppler, cardiac output, M-mode measurement, minimum scan numbers, and pass-grade criteria. Regarding objective criteria for image-acquisition and image-interpretation quality, the panel agreed on maintaining the same criteria for formative and summative assessment, to categorize BCCE findings as major vs minor and a standardized approach to errors, criteria for readiness for summative assessment, and supervisory options. Interpretation: In conclusion, this expert consensus statement presents comprehensive evidence-based recommendations on longitudinal BCCE training. However, these recommendations require prospective validation.
KW - Delphi process
KW - basic echocardiography
KW - consensus statement
KW - critical care
KW - guideline
UR - http://www.scopus.com/inward/record.url?scp=85123009494&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.chest.2021.08.077
DO - https://doi.org/10.1016/j.chest.2021.08.077
M3 - Article
C2 - 34508739
SN - 0012-3692
VL - 161
SP - 492
EP - 503
JO - Chest
JF - Chest
IS - 2
ER -