European Journal of Echocardiography Advance Access originally published online on August 15, 2007
European Journal of Echocardiography 2008 9(3):373-380; doi:10.1016/j.euje.2007.06.011
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An intensive interactive course for 3D echocardiography: is ‘crop till you drop’ an effective learning strategy?
1 University of Queensland, Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Q4102, Australia
2 King's College Hospital, London, UK
3 Children's Heart Program, Charleston, SC, USA
4 Philips Medical Systems, USA
Received 13 March 2007; accepted after revision 2 June 2007; online publish-ahead-of-print 15 August 2007.
* Corresponding author. Tel: +61 7 3240 5340; fax: +61 7 3240 5399. E-mail address: t.marwick{at}uq.edu.au (T.H. Marwick)
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Abstract |
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Background: Three-dimensional echocardiography (3DE) appears to show incremental benefit over two-dimensional echocardiography (2DE), but it's uptake has been slow. We tested attendees before and after an intensive interactive training course to identify its efficacy.
Methods: Attendees (n = 35, 23 cardiologists, 12 sonographers) were shown how to use 3DE review software and asked to identify the pathology of five patients (wall motion abnormality, peri-prosthetic mitral regurgitation, subaortic membrane, small ventricular septal defect, submitral stenosis) on 2D and 3D images. In the following one and a half-day interactive teaching course, brief presentations on application of 3DE for assessment of wall motion, valve and congenital abnormalities were followed by review of 3D datasets, during which the attendees made their own interpretations before being shown the optimal viewing strategy. Test cases were not discussed and the test was repeated at the end of the course.
Results: Most attendees (57%) had access but with little or no use of a 3DE system. Three-dimensional echocardiography had no incremental value before training. After training, overall correct responses significantly improved compared with baseline interpretation, although improvement was not the same for all diagnoses. All groups (cardiologists vs. sonographers, inexperienced vs. moderately experienced reviewers) improved similarly.
Conclusions: Incorporation of 3DE into standard practice may be limited by inexperience. An interactive teaching course with rehearsal and direct mentoring appears to overcome this limitation and may improve the uptake of this technique.
Keywords: Three-dimensional echocardiography; Two-dimensional echocardiography