The transthoracic echocardiographic skills of registrars in a department of anaesthesiology

Abstract

Background: Research has shown the value of integrating point-of-care ultrasonography (POCUS) into daily practice and has highlighted the lack of competency in transthoracic echocardiographic (TTE) skill among anaesthesiology registrars. The aim of this study was to determine the level of TTE skill of anaesthesiology registrars at the University of the Witwatersrand (Wits) using an objective structured clinical examination (OSCE). Methods: This research study employed a cross-sectional research design. Convenience sampling was used and 27 registrars were enrolled in this study. The OSCE consisted of two practical stations (Stations 1 and 2) and two clinical pathology stations (Stations 3 and 4). Adequate TTE skill was defined as competency in both the practical and clinical stations and an overall pass score of 70% was used. Results: The overall mean (SD) score obtained for the OSCE was 45.2% (23%). In comparing the TTE skill of registrars who have completed a cardiac rotation and have completed an accredited course with those who have not, no significant differences were found in the pass scores. Registrars who had completed an accredited TTE course performed significantly better in Stations 3 and 4 (p = 0.014). Of the registrars, 37% obtained a pass score for practical stations and 14.8% for the clinical stations with only 11.1% achieving an overall pass score indicating TTE competency. No significant difference in pass scores was found with the different categories of registrars. There was a strong positive significant correlation between completing more TTEs and the scores obtained (r = 0.540, p = 0.004). Completing more TTEs was associated with a higher score. Conclusion: Findings from this study suggest that the current skill level of registrars performing TTEs at our department is not sufficient to achieve clinical competency and that the training may not be initiated early enough in the registrar programme