Focused echocardiography: Dyad versus individual training in an authentic clinical context

Kay Choong See*, Joo Wei Chua, Danielle Verstegen, Jeroen J. G. Van Merrienboer, Walther N. Van Mook

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Purpose: Echocardiography is increasingly being taught to intensive care unit residents. Current training methods require teachers to closely supervise trainees individually, and are time-intensive. To reduce the time burden, dyad training (training in pairs) under simulation conditions has been shown to be non-inferior to individual training. We aimed to validate these preliminary results for focused subcostal echocardiography (FSE), in an authentic clinical context.

Materials and methods: We conducted a quasi-experimental study within a 20-bed medical intensive care unit from June 2016 to March 2017. For supervised practice, residents were divided into individual versus dyad training groups. Residents then performed at least five FSE examinations, which were remotely scored by a blinded observer for image quality and correct interpretation. The main outcome measure was the mean composite image quality and interpretation score for the first five echoes done under indirect supervision (composite score range 1-8).

Results: 16 residents received individual training and 17 residents received dyad training. The mean composite score did not differ between the individual and dyad training groups (6.0 +/- 0.4 versus 5.9 +/- 0.4, 95% CI of difference - 0.2 to 0.4).

Conclusions: Assuming a 1-point non-inferiority threshold for the mean composite score, dyad training for FSE was non-inferior to individual training. (C) 2018 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)50-55
Number of pages6
JournalJournal of Critical Care
Publication statusPublished - Feb 2019


  • Echocardiography
  • Ultrasonography
  • Education
  • Internship and residency
  • Intensive care units
  • Non-randomized controlled trials as topic


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