PoCUS identification of distal biceps tendon rupture: a case report.

BACKGROUND: In the Emergency Department (ED), patients may present with various injuries that damage muscles, tendons, ligaments, and bony structures. Fractures, joint dislocations, strains, and sprains are prevalent among them. However, distal biceps tendon ruptures are uncommon. CASE REPORT: Here, we report a case of a young man presented to the ED with a complaint of left arm pain following a martial arts activity. The diagnosis of distal biceps tendon rupture was made using a point-of-care ultrasound (PoCUS), and an early referral to the orthopedic service was provided. CONCLUSION: This case highlights the utility of point-of-care ultrasound in assessing musculoskeletal injuries in the ED. Early incorporation of PoCUS into routine clinical practice can potentially improve the overall care of musculoskeletal injuries.

From compression to diagnosis: identification of superior vena cava syndrome using point-of-care ultrasound in the emergency department.

BACKGROUND: Superior vena cava (SVC) syndrome is an urgent condition arising from restricted blood flow through the SVC, often linked to factors like malignancy, thrombosis, or infections. Typically, confirmation of the diagnosis involves computed tomography. However, many patients experience respiratory distress and cannot lie supine. Given the increasing integration of point-of-care ultrasound in emergency medicine, it is important to be familiar with findings that are suggestive of this important condition. CASE REPORT: In this case report, we highlight a young patient presenting to the emergency department with superior vena cava syndrome symptoms, successfully diagnosed using point-of-care ultrasound. CONCLUSION: This case highlights the utility of point-of-care ultrasound based diagnosis of SVC syndrome and upper arm deep venous thrombosis in a patient with underlying malignancy which ultimately led to early involvement of relevant speciality for initiation of treatment.

Self-administered at-home lung ultrasound with remote guidance in patients without clinical training.

BACKGROUND: Access to timely and accurate diagnostic imaging is essential for high-quality healthcare. Point-of-care ultrasound has been shown to be accessible and effective in many aspects of healthcare, including assessing changes in lung pathology. However, few studies have examined self-administered at-home lung ultrasound (SAAH-LUS), in particular performed by non-clinical patients (NCPs). RESEARCH QUESTION: Are NCPs able to perform SAAH-LUS using remote teleguidance and produce interpretable images? STUDY DESIGN: Patients were enrolled to the study in a mix of in-person and virtual recruitment, and shipped a smartphone as well as a point of care ultrasound device. Tele-guidance was provided by a remote physician using software integrated with the point of care ultrasound device, allowing real-time remote visualization and guidance of a patient scanning their own chest. A post-intervention survey was conducted to assess patient satisfaction, feasibility, and acceptability of SAAH-LUS. Two POCUS expert reviewers reviewed the scans for interpretability, and inter-rater agreement between the two reviewers was also computed. RESULTS: Eighteen patients successfully underwent 7-14 days of daily telemedicine in parallel to daily SAAH-LUS. Across 1339 scans obtained from ten different lung zones, the average proportion of interpretability was 96% with a chance-corrected agreement, or Cohen's kappa, reported as κ = 0.67 (significant agreement). 100% of NCPs surveyed found SAAH-LUS to be a positive experience, particularly for its ease of operation and ability to increase access to healthcare services. INTERPRETATION: This study demonstrates that NCPs can obtain interpretable LUS images at home, highlighting the potential for SAAH-LUS to increase diagnostic capacity, particularly for rural and remote regions where complex imaging and healthcare providers are difficult to obtain. Trial registration The clinical trials has been registered (clinicaltrials.gov). REGISTRATION NUMBER: NCT04967729.

POCUS literature primer: key papers on POCUS in cardiac arrest and shock.

OBJECTIVE: The objective of this study is to identify the top five most influential papers published on the use of point-of-care ultrasound (POCUS) in cardiac arrest and the top five most influential papers on the use of POCUS in shock in adult patients. METHODS: An expert panel of 14 members was recruited from the Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee and the Canadian Ultrasound Fellowship Collaborative. The members of the panel are ultrasound fellowship trained or equivalent, are engaged in POCUS research, and are leaders in POCUS locally and nationally in Canada. A modified Delphi process was used, consisting of three rounds of sequential surveys and discussion to achieve consensus on the top five most influential papers for the use of POCUS in cardiac arrest and shock. RESULTS: The panel identified 39 relevant papers on POCUS in cardiac arrest and 42 relevant papers on POCUS in shock. All panel members participated in all three rounds of the modified Delphi process, and we ultimately identified the top five most influential papers on POCUS in cardiac arrest and also on POCUS in shock. Studies include descriptions and analysis of safe POCUS protocols that add value from a diagnostic and prognostic perspective in both populations during resuscitation. CONCLUSION: We have developed a reading list of the top five influential papers on the use of POCUS in cardiac arrest and shock to better inform residents, fellows, clinicians, and researchers on integrating and studying POCUS in a more evidence-based manner.

RéSUMé: OBJECTIF: L'objectif de cette étude est d'identifier les cinq articles les plus influents publiés sur l'utilisation de l'échographie au point de soin (POCUS) dans l'arrêt cardiaque et les cinq articles les plus influents sur l'utilisation de POCUS dans le choc chez les patients adultes. MéTHODES: Un comité d'experts composé de 14 membres a été recruté par le Comité d'échographie d'urgence de l'Association canadienne des médecins d'urgence (ACMU) et le Canadian Ultrasound Fellowship Collaborative. Les membres du comité sont formés en échographie ou l'équivalent, participent à la recherche sur le POCUS et sont des chefs de file du POCUS à l'échelle locale et nationale au Canada. Un processus Delphi modifié a été utilisé, consistant en trois séries de sondages séquentiels et de discussions pour parvenir à un consensus sur les cinq articles les plus influents pour l'utilisation de POCUS dans les arrêts cardiaques et les chocs. RéSULTATS: Le panel a identifié 39 articles pertinents sur le POCUS en arrêt cardiaque et 42 articles pertinents sur le POCUS en état de choc. Tous les membres du panel ont participé aux trois cycles du processus Delphi modifié, et nous avons finalement identifié les cinq articles les plus influents sur le POCUS en arrêt cardiaque et aussi sur le POCUS en état de choc. Les études comprennent des descriptions et des analyses de protocoles POCUS sûrs qui ajoutent de la valeur d'un point de vue diagnostique et pronostique dans les deux populations pendant la réanimation. CONCLUSION: Nous avons dressé une liste de lecture des cinq principaux articles influents sur l'utilisation du POCUS en cas d'arrêt cardiaque et de choc afin de mieux informer les résidents, les boursiers, les cliniciens et les chercheurs sur l'intégration et l'étude du POCUS d'une manière plus factuelle.

Carotid Flow Time Compared with Invasive Monitoring as a Predictor of Volume Responsiveness in ICU patients.

Objectives: Identifying patients who will have an increase in their cardiac output from volume administration is difficult to identify. We propose the use of carotid flow time, which is a non-invasive means to determine if a patient is volume responsive. Methods: Patients admitted to a critical care unit with a pulmonary artery catheter in place were enrolled. We perform a carotid flow time and pulmonary artery catheter measurement of cardiac output pre and post-passive leg raise and comparing the two. An increase of 10% change in the pre- vs. post-passive leg raise measurement would be indicative of a patient who is volume responsive. Results: We identified 8 patients who were volume responsive as determined by the gold standard pulmonary artery catheter. The sensitivity 87.5% and specificity 90.9%. Pearson correlation coefficient between PA-CO measurements and CFT was r=0.8316, indicative of strong correlation between the two measurements. Conclusion: In our patient sample of critically ill patients with pulmonary artery catheters, we found a strong correlation between corrected carotid flow times and cardiac output measurements from pulmonary artery catheters.

Structured Cardiac Assessment Outperforms Visual Estimation in Novice Ultrasound Users: A Randomized Controlled Trial.

BACKGROUND: Two evidence-based techniques to determine left ventricular (LV) systolic function are taught in emergency medicine curricula. The first is a "structured approach," which qualitatively evaluates LV fractional shortening, E-point septal separation, and LV diameter. The other is the "eyeball method," which qualitatively estimates the LV ejection fraction (LVEF). OBJECTIVE: The aim of this study was to determine whether the structured approach or the eyeball method was superior for teaching LVEF estimation to novices. METHODS: Medical students were recruited to participate in our randomized controlled trial. Participants were randomized to the structured approach group or eyeball method group and completed one of two 15-min educational modules. Participants subsequently interpreted 12 echocardiogram clips to determine LV function. The primary outcome was the percentage of correct interpretations as determined by a cardiologist. RESULTS: Seventy-four participants were invited to participate and 32 completed the study (15 in the structured approach and 17 in the eyeball method groups). The majority (30 of 32 [93.75%]) were first- and second-year medical students with no prior ultrasound training. The mean time to complete the training was similar between groups (16.8 vs. 17.8 min; p = 0.66). The primary outcome of percent of correct interpretations was significantly higher in the structured approach group compared with the eyeball method group (88.9% vs. 73.0%; p < 0.01). CONCLUSIONS: Training novice ultrasound users in a structured qualitative LV assessment method was more effective than the eyeball method. Learners were able to achieve high accuracy after a brief training intervention. These results may help inform best practices for undergraduate ultrasound curriculum development.

Point-of-Care Ultrasound (POCUS) Literature Primer: Key Papers on Renal and Biliary POCUS.

Objective The objective of this study is to identify the top five influential papers published on renal point-of-care ultrasound (POCUS) and the top five influential papers on biliary POCUS in adult patients. Methods A 14-member expert panel was recruited from the Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee and the Canadian Ultrasound Fellowship Collaborative. All panel members have had ultrasound fellowship training or equivalent, are actively engaged in POCUS scholarship, and are involved with POCUS at their local site and nationally in Canada. We used a modified Delphi process consisting of three rounds of sequential surveys and discussion to achieve consensus on the top five influential papers for renal POCUS and biliary POCUS. Results The panel identified 27 relevant papers on renal POCUS and 30 relevant papers on biliary POCUS. All panel members participated in all three rounds of the modified Delphi process, and after completing this process, we identified the five most influential papers on renal POCUS and the five most influential papers on biliary POCUS. Conclusion We have developed a list, based on expert opinion, of the top five influential papers on renal and biliary POCUS to better inform all trainees and clinicians on how to use these applications in a more evidence-based manner. This list will also be of interest to clinicians and researchers who strive to further advance the field of POCUS.

Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series.

BACKGROUND: Transesophageal echocardiography (TEE) is an emerging tool that can aid emergency physicians in treating patients in cardiac arrest and undifferentiated shock. TEE can aid in diagnosis, resuscitation, identify cardiac rhythms, guide chest compression vectors, and shorten sonographic pulse checks. This study evaluated the proportion of patients who underwent a change in their resuscitation management as a result of emergency department resuscitative TEE. METHODS: This was a single-centre case series of 25 patients who underwent ED resuscitative TEE from 2015 to 2019. The objective of this study is to evaluate the feasibility and clinical impact of resuscitative TEE in critically ill patients in the emergency department. Data including changes in working diagnosis, complications, patient disposition, and survival to hospital discharge were also collected. RESULTS: 25 patients (median age 71, 40% female) underwent ED resuscitative TEE. All patients were intubated prior to probe insertion and adequate TEE views were obtained for every patient. The most common indications for resuscitative TEE were cardiac arrest (64%) and undifferentiated shock (28%). Resuscitation management changed in 76% (N = 19) and working diagnosis changed in 76% (N = 19) of patients. Ten patients died in the ED, 15 were admitted to hospital, and eight survived to hospital discharge. There were no immediate complications (0/15) and two delayed complications (2/15), both of which were minor gastrointestinal bleeding. CONCLUSIONS: The use of ED resuscitative TEE is a practical modality that provides useful diagnostic and therapeutic information for critically ill patients in the emergency department, with an excellent rate of adequate cardiac visualization, and a low complication rate.

Optimizing simulator-based training for emergency transesophageal echocardiography: A randomized controlled trial.

Background: Resuscitative clinician-performed transesophageal echocardiography (TEE) is a relatively novel ultrasound application; however, optimal teaching methods have not been determined. Previous studies have demonstrated that variable practice (VP), where practice conditions are changed, may improve learning of procedural skills compared with blocked practice (BP), where practice conditions are kept constant. We compared VP and BP for teaching resuscitative TEE to emergency medicine residents using a simulator. Methods: Emergency medicine residents with no prior TEE experience were randomized to the BP or VP groups. The BP group practiced 10 repetitions of a fixed five-view TEE sequence, while the VP group practiced 10 different random five-view TEE sequences on a simulator. Participants completed a performance assessment immediately after training and a transfer test 2 weeks after training. Ultrasound images and transducer motion metrics were captured by the simulator for blinded analysis. The primary outcome was the percentage of successful views on the transfer test. Results: Twenty-eight participants completed the study (14 in the BP group, 14 in the VP group). The BP group had a higher rate of successful views compared with the VP group on the transfer test (93.6% vs. 77.6%; p = 0.002). The BP group also had higher image quality on a 5-point scale (3.3 vs. 2.9; p = 0.01) and fewer probe angular changes (2982.5 degrees vs. 4239.8 degrees; p = 0.04). There were no statistically significant differences between the groups for the rate of correct diagnoses, confidence level, or scan time. Conclusions: Practicing a fixed sequence of views was more effective than a variable sequence of views for learning resuscitative TEE on a simulator. These results should be validated in TEE scans performed in the clinical environment.

Point of Care Ultrasound Literature Primer: Key Papers on Focused Assessment With Sonography in Trauma (FAST) and Extended FAST.

Objective The objective of this study is to identify the top five most influential papers published on focused assessment with sonography in trauma (FAST) and the top five most influential papers on the extended FAST (E-FAST) in adult patients. Methods An expert panel was recruited from the Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee and the Canadian Ultrasound Fellowship Collaborative. These experts are ultrasound fellowship-trained or equivalent, are involved with point-of-care ultrasound (POCUS) research and scholarship, and are leaders in both the POCUS program at their local site and within the national Canadian POCUS community. This 14-member expert group used a modified Delphi process consisting of three rounds of sequential surveys and discussion to achieve consensus on the top five most influential papers for FAST and E-FAST. Results The expert panel identified 56 relevant papers on FAST and 40 relevant papers on E-FAST. After completing all three rounds of the modified Delphi process, the authors identified the top five most influential papers on FAST and the top five most influential papers on E-FAST. Conclusion We have developed a reading list of the top five influential papers for FAST and E-FAST that will benefit residents, fellows, and clinicians who are interested in using POCUS in an evidence-informed manner.

Assessment of changes in gaze patterns during training in point-of-care ultrasound.

BACKGROUND: Point-of-care ultrasound (POCUS) is a core skill in emergency medicine (EM), however, there is a lack of objective competency measures. Eye-tracking technology is a potentially useful assessment tool, as gaze patterns can reliably discriminate between experts and novices across medical specialties. We aim to determine if gaze metrics change in an independent and predictable manner during ultrasound training. METHODS: A convenience sample of first-year residents from a single academic emergency department was recruited. Participants interpreted 16 ultrasound videos of the focused assessment with sonography for trauma (FAST) scan while their gaze patterns were recorded using a commercially available eye-tracking device. The intervention group then completed an introductory ultrasound course whereas the control group received no additional education. The gaze assessment was subsequently repeated. The primary outcome was total gaze duration on the area of interest (AOI). Secondary outcomes included time to fixation, mean duration of first fixation and mean number of fixations on the AOI. RESULTS: 10 EM residents in the intervention group and 10 non-EM residents in the control group completed the study. After training, there was an 8.8 s increase in the total gaze time on the AOI in the intervention group compared to a 4.0 s decrease in the control group (p = .03). EM residents were also 3.8 s quicker to fixate on the AOI whereas the control group became 2.5 s slower (p = .04). There were no significant interactions on the number of fixations (0.43 vs. 0.18, p = .65) or duration of first fixation on the AOI (0.02 s vs. 0.06 s, p = .63). CONCLUSIONS: There are significant and quantifiable changes in gaze metrics, which occur with incremental learning after an ultrasound course. Further research is needed to validate the serial use of eye-tracking technology in following a learner's progress toward competency in point-of-care ultrasound image interpretation.

Point-of-care ultrasound-guided regional anaesthesia in older ED patients with hip fractures: a study to test the feasibility of a training programme and time needed to complete nerve blocks by ED physicians after training.

OBJECTIVES: Point-of-care ultrasound-guided regional anaesthesia (POCUS-GRA) provides safe, rapid analgesia for older people with hip fractures but is rarely performed in the emergency department (ED). Self-perceived inadequate training and time to perform POCUS-GRA are the two most important barriers. Our objective is to assess the feasibility of a proposed multicentre, stepped-wedge cluster randomised clinical trial (RCT) to assess the impact of a knowledge-to-practice (KTP) intervention on delirium. DESIGN: Open-label feasibility study. SETTING: An academic tertiary care Canadian ED (annual visits 60 000). PARTICIPANTS: Emergency physicians working at least one ED shift per week, excluding those already performing POCUS-GRA more than four times per year. INTERVENTION: A KTP intervention, including 2-hour structured training sessions with procedure bundle and email reminders. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary feasibility outcome is the proportion of eligible physicians that completed training and subsequently performed POCUS-GRA. Secondary outcome is the time needed to complete POCUS-GRA. We also test the feasibility of the enrolment, consent and randomisation processes for the future stepped-wedge cluster RCT (NCT02892968). RESULTS: Of 36 emergency physicians, 4 (12%) were excluded or declined participation. All remaining 32 emergency physicians completed training and 31 subsequently treated at least one eligible patient. Collectively, 27/31 (87.1%) performed 102 POCUS-GRA blocks (range 1-20 blocks per physician). The median (IQR) time to perform blocks was 15 (10-20) min, and reduction in pain was 6/10 (3-7) following POCUS-GRA. There were no reported complications. CONCLUSION: Our KTP intervention, consent process and randomisation were feasible. The time to perform POCUS-GRA rarely exceeded 30 min, Our findings reinforce the existing data on the safety and effectiveness of POCUS-GRA, mitigate perceived barriers to more widespread adoption and demonstrate the feasibility of trialling this intervention for the proposed stepped-wedge cluster RCT. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov #02892968.

Exploring Eye-tracking Technology as an Assessment Tool for Point-of-care Ultrasound Training.

OBJECTIVES: Eye-tracking technology has emerged as a potentially useful learner assessment tool in several medical specialties. In the fields of general surgery and anesthesiology, it has been shown to reliably differentiate between different levels of expertise in procedural skills. In the field of radiology, it has been shown to be a valid assessment tool for diagnostic test interpretation. Current methods of competency assessment in point-of-care ultrasound (POCUS) remain a challenge, because they require significant direct observation time by an instructor. The purpose of this study was to determine if eye-tracking technology can accurately distinguish between novice and experts in the interpretation of POCUS clips, specifically of the focused assessment using sonography in trauma (FAST) scan. METHODS: A convenience sample of medical students, residents, and emergency physicians from a single academic emergency department were invited to participate. Participants included both novices and experts in POCUS. Each participant completed a baseline questionnaire and viewed 16 video clips of a FAST ultrasound examination while their gaze patterns were recorded by a commercially available eye-tracking device. The primary outcome was total gaze time on the area of interest (AOI). Secondary outcomes included total time to fixation, mean number of fixations, and mean duration of first fixation on the AOI. RESULTS: Fifteen novices and 15 experts completed this study. For total gaze time on the AOI, experts fixated their gaze significantly longer than novices (75.8 ± 16.2 seconds vs. 56.6 ± 12.8 seconds, p = 0.001). Similarly, experts were significantly faster to fixate on the AOI and had a higher fixation count on the AOI (8.5 ± 4.0 seconds vs. 15.1 ± 6.8 seconds, p = 0.003; and 170 ± 30 vs. 143 ± 28 seconds, p = 0.016). There were no differences on the mean duration of first fixation on the AOI (0.42 ± 0.12 seconds vs. 0.39 ± 0.09 seconds, p = 0.467). CONCLUSION: Eye-tracking technology shows the potential to differentiate between experts and novices by their gaze patterns on video clips of FAST examinations. The total gaze time on the AOI may be a useful metric to help in the assessment of competency in POCUS image interpretation. In addition, the evaluation of gaze patterns may help educators identify causes of interpretation errors. Future studies are needed to further validate these metrics in a larger cohort.

Checking the pulse in the 21st century: Interobserver reliability of carotid pulse detection by point-of-care ultrasound.

INTRODUCTION: Detection of a pulse is crucial to decision-making in the care of patients who are in cardiac arrest, however, the current standard of manual pulse palpation is unreliable. An emerging alternative is the use of point-of-care ultrasound (POCUS) for direct assessment of the carotid pulse. The primary objective of this study is to determine the interobserver reliability for physician interpretation of pre-recorded point-of-care ultrasound pulse-check clips for patients who are in cardiac arrest. METHODS: We conducted a web-based survey of residents and physicians working in an academic center. Participants were shown a tutorial demonstrating POCUS detection of the carotid pulse and then asked to interpret 15 carotid pulse ultrasound clips from patients who were in cardiac arrest. The primary outcome was interobserver reliability for carotid pulse assessment. Secondary outcomes included interobserver reliability stratified by physician role and POCUS experience, median tutorial and median pulse assessment duration. Interobserver reliability was determined by Krippendorff's ⍺. RESULTS: 68 participants completed the study, with a response rate of 75%. There was high interobserver reliability for pulse assessment amongst all study participants (⍺ = 0.874, 95% CI 0.869 to 0.879). All sub-groups had ⍺ greater than 0.8. Median tutorial duration was 35 s (IQR 29). Median pulse assessment duration was 6 s (IQR 5) with 76% of assessments completed within 10 s. CONCLUSION: Interpretation of the carotid pulse by POCUS showed high interobserver reliability. Further work must be done to determine the performance of POCUS pulse assessment in real-time for patients who are in cardiac arrest.

The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound.

BACKGROUND: During cardiopulmonary resuscitation, pulse checks must be rapid and accurate. Despite the importance placed on the detection of a pulse, several studies have shown that health care providers have poor accuracy for detection of central pulses by palpation. To date, the use of point-of-care ultrasound (POCUS) in cardiac arrest has focused on the presence of cardiac standstill and diagnosing reversible causes of the arrest. OBJECTIVE: This case series highlights a simple, novel approach to determine whether pulses are present or absent by using POCUS compression of the central arteries. DISCUSSION: Using this technique, we found that a POCUS pulse check can be consistently performed in < 5 s and is clearly determinate, even when palpation yields indeterminate results. CONCLUSIONS: In this case series, the POCUS pulse check was a valuable adjunct that helped to change management for critically ill patients. Future prospective studies are required to determine the accuracy of this technique and the impact on patient outcomes in a larger cohort.

Simulator-based training for learning resuscitative transesophageal echocardiography.

OBJECTIVES: Transesophageal echocardiography (TEE) is a relatively new resuscitation tool in the emergency department. Recent studies have demonstrated that it can impact diagnosis and management of critically ill patients. The objective of this study is to determine the effectiveness of a simulation-based curriculum for teaching emergency medicine residents a five-view TEE protocol. METHODS: Emergency medicine residents with previous ultrasound experience were invited to attend a 1-hour TEE training session. The training consisted of a didactic lecture followed by guided practice on a simulator. Performance was measured prior to training, after the training session, and by a transfer test 1 to 2 weeks after training. The primary outcome was the percentage of successful image generation using a scoring tool by two blinded reviewers. RESULTS: Twenty-two residents completed the study. The percentage of successful views increased from 44.5% (SD 27.9) at baseline to 98.6% (SD 3.5) after training (p < 0.001), and was 86.8% (SD 12.1) on transfer testing (p < 0.001). CONCLUSION: A brief simulation-based teaching session was effective for teaching emergency medicine residents a five-view resuscitative TEE protocol. Future studies are needed to determine optimal methods for long-term skill retention.

OBJECTIF: Le recours à l'échocardiographie transœsophagienne (ETO) dans les cas de réanimation est relativement nouveau au service des urgences. D'après des études récentes, les résultats de l'examen peuvent avoir une incidence sur le diagnostic et la prise en charge de maladies très graves. L'étude visait donc à déterminer l'efficacité d'une séance de formation par simulation sur un protocole d'ETO en cinq prises de vue à des résidents en médecine d'urgence (MU). MÉTHODE: Des résidents en MU ayant une expérience antérieure en échographie ont été invités à participer à une séance d'une heure sur l'ETO. Celle-ci se divisait en deux parties : enseignement magistral et application pratique guidée sur simulateur. Une mesure de la performance a été effectuée avant et après la séance de formation, puis de 1 à 2 semaines après celle-ci à l'aide d'un test d'application des connaissances. Le critère principal consistait dans le pourcentage de la production d'images réussies d'images et en leur évaluation par deux examinateurs tenus dans l'ignorance des faits, à l'aide d'une méthode de pointage. RÉSULTATS: Au total, 22 résidents ont terminé l'étude. Le pourcentage de prises de vue réussies est passé de 44,5% (écart-type [σ] = 27,9) au départ à 98,6% (σ = 3,5) après la formation (p < 0,001), et celui-ci a atteint 86,8% (σ = 12,1) au test d'application des connaissances (p < 0,001). CONCLUSION: La tenue d'une brève séance de formation par simulation s'est révélée efficace dans l'enseignement d'un protocole d'ETO en cinq prises de vue à des résidents en MU. Il faudrait toutefois mener d'autres études afin de déterminer les meilleures méthodes d'enseignement possible favorisant la mémorisation de la matière à long terme.