Assessment of Perioperative Ultrasound Workflow Understanding: A Consensus

• Published in: Journal of cardiothoracic and vascular anesthesia 2017-02, Vol.31 (1), p.197-202
• Main Authors: Yeh, Lu, MD, Montealegre-Gallegos, Mario, MD, Mahmood, Feroze, MD, Hess, Philip E., MD, Shnider, Marc, MD, Mitchell, John D., MD, Jones, Stephanie B., MD, Mashari, Azad, MD, Wong, Vanessa, BS, Matyal, Robina, MD
• Format: Article
• Language: English
• Subjects: Anesthesia & Perioperative Care; anesthesia education; Anesthesiology - education; Anesthesiology - organization & administration; Anesthesiology - standards; Clinical Competence; Critical Care; Education, Medical, Graduate - methods; Focus Groups; Humans; Perioperative Care - methods; Perioperative Care - standards; perioperative ultrasound; proficiency; Task Performance and Analysis; Ultrasonography - standards; United States; Workflow
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2016.07.008

Objectives Understanding of the workflow of perioperative ultrasound (US) examination is an integral component of proficiency. Workflow consists of the practical steps prior to executing an US examination (e.g. equipment operation). Whereas other proficiency components (i.e. cognitive knowledge and manual dexterity) can be tested, workflow understanding is difficult to define and assess due to its contextual and institution-specific nature. Our objective was to define the workflow components of specific perioperative US applications using an iterative process to reach a consensus opinion. Design Expert consensus, survey study. Setting Tertiary university hospital. Participants We sought expert consensus among a focus group of 9 members of our department with experience in perioperative US. Afterwards, we surveyed 257 anesthesia faculty members from 133 academic centers across the United States. Interventions We designed a preliminary list of tasks to establish the expectations of workflow understanding by an anesthesiology resident prior to clinical exposure to perioperative US. This list was modified by a focus group through an iterative process. Afterwards, a survey was sent to faculty members nationwide, and Likert scale ratings for each task were obtained and reviewed during a second round. Measurements and Main Results Consensus among members of the focus group was reached after 2 iterations. 72 participants responded to the nationwide survey (28%), and consensus was reached after the second round (Cronbach’s α = 0.99, ICC = 0.99) on a final list of 46 workflow-related tasks. Conclusions Specific components of perioperative US workflow were identified. Evaluation of workflow understanding may be combined with cognitive knowledge and manual dexterity testing for assessing proficiency in perioperative US.