Although the use of transesophageal echocardiography (TEE) may improve cardiac arrest management, the incidence of cardiac arrest cases at some hospitals is low which means emergency physicians (EP’s) may have limited opportunities to perform TEE in clinical or educational settings. Standardized checklists, such as those used in simulation-based mastery learning (SBML), have been employed to improve trainee performance for rarely performed procedures, including other point-of-care (POC) ultrasound procedures. To date, there is no validated checklist for performing POC TEE in the emergency department (ED) setting. We are developing and validating an SBML checklist containing the critical actions for performing POC TEE that can be used for future procedural skills training.
A preliminary checklist was developed and disseminated to TEE experts nationwide, and a modified Delphi was used to revise it and determine critical actions. We are also comparing trainee confidence in using TEE after training. Our final Mastery Learning checklist is comprised of 43 items after 3 Delphi rounds. Almost perfect agreement was achieved among the raters. The mean confidence in the use of TEE improved from 27.7 to 82.1 points which was significant.