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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2015, Vol. 9 Issue (1) : 123-128     DOI: 10.1007/s11684-014-0366-7
COMMENTARY |
Essential training steps to achieving competency in the basic intraoperative transesophageal echocardiography examination for Chinese anesthesiologists
Yong G. Peng1,*(),Haibo Song2,E. Wang3,Weipeng Wang4,Jin Liu2
1. Department of Anesthesiology, College of Medicine, University of Florida Shands Hospital, Gainesville, FL 32610, USA
2. Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, China
3. Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, China
4. Department of Anesthesiology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
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Abstract  

Guidelines for the intraoperative transesophageal echocardiography (TEE) examination have defined a detailed standard for medical professionals, particularly anesthesiologists, on how a TEE exam should proceed. Over the years, TEE has gained substantial popularity and emerged as a preferred monitoring modality to aid in perioperative management and decision making during hemodynamic instability situations or critical care settings. TEE training pathways and practice guidelines have been well established in western countries and many regions of the world. However, TEE training and practice information for anesthesiologists are lacking in China. As innovative technologies develop, other educational models have emerged to aid in obtaining competency in basic TEE exam. Hence, establishing a consensus on the ideal TEE training approach for anesthesiologists in China is urgently needed. Developing an effective curriculum that can be incorporated into an anesthesiology resident’s overall training is also necessary to provide knowledge and skills toward competency in basic TEE exam. With evolving medical system reforms and increasing demands for intraoperative hemodynamic monitoring to accommodate surgical innovations, anesthesiology professionals are increasingly obliged to perform intraoperative TEE exams in their current and future practices. To overcome obstacles and achieve significant progress in using the TEE modality to help in intraoperative management and surgical decision making, publishing basic TEE training guidelines for China’s anesthesiologists is an important endeavor.

Keywords transesophageal echocardiography      guidelines      training      competency     
Corresponding Authors: Yong G. Peng   
Online First Date: 24 October 2014    Issue Date: 02 March 2015
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0366-7     OR     http://academic.hep.com.cn/fmd/EN/Y2015/V9/I1/123
Modules Training period Cases proposed TEE course Hands on Special setup
CanadianAnesthesiology 3 months 150 cases 50 designated CME hours 100 personally performed cases Continue to perform TEE at 50 case/year
Europe Over 1 year 125 cases/12 months Computer-written exam 125 personally performed cases Audit 15 casesevaluated by the examiners
Australia and New Zealand 10 weeks to 2 years 50 cases supervised; 50 casesunsupervised Online course 100 personally performed cases Supervised reviewof 100 cases
ACEP* 11 applications of clinical ultrasound 2- to 3-day course 6–8 h of skill maneuvers 3–4 h of didactic for cardiac US
ACCP# Complete online learning module 3-day course Complete online portfolio Pass assessment exam
Tab.1  Comparison of training models in obtaining competency on basic ultrasound (US)/TEE skills
Training requirement Expectation
Training duration 3 months
Training center Qualified and designated center
TEE specific courseTotal number of cases evaluated 20 equivalent CME hours150 cases*
Personal performance with supervision(acquisition, interpretation, and reporting) 50 cases
Pre- or postoperative basic TEE exam with report 50 cases (include 10 cases each for coronary artery disease, valvular disease, cardiomyopathy, or congestive heart failure cases)
TEE classic case review with qualified echocardiographic expert 50 cases ranging from spectrum of cardiac pathologies
Tab.2  Proposed basic TEE training requirements for Chinese anesthesiologists
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