Focused transthoracic echocardiography curriculum for advanced practice providers assures good concordance with intensivists at echocardiography

摘要

ObjectiveTo describe a focused transthoracic echocardiography (FoTE) curriculum for advanced practice providers (APPs) for echocardiography-driven diagnosis of shock in critically ill patients. MethodsTwelve APPs in 4 intensive care units at an academic medical center received didactic sessions on FoTE, including 1-on-1 proctorship with a registered cardiac sonographer. For a period of 6 months the trainees performed individual studies, then they performed FoTE examinations on critically ill patients; their diagnoses were compared with those of experienced intensivists for the same patients. ResultsAfter 6 months of multiple steps of training, APPs could acquire good echocardiographic views, achieving a good inter-rater agreement (Cohen’s κ of 0.745 [95% CI, 0.385–1.0;P< .01]) in the diagnosis of shock when compared to experienced intensivists. ConclusionsStructured FoTE curriculum enables APPs to have reasonably good diagnostic concordance with intensivists in an echocardiography-driven diagnosis of shock in critically ill patients.