“REmote SOLutions for Telementoring pocus-Echocardiography”, a study using Reacts, presented at the Society of Cardiovascular Anesthesia 2017 annual meeting

2017-05-03

Worldwide, hundreds of thousands of ultrasound users in various medical disciplines require training and/or supervision. The problem for many professionals is obtaining access to adequate, quality training, which often presents a significant bottleneck to improving care.

Dr Choo et al’s team at the Cardiac Anesthesiology department of the University of Ottawa Heart Institute presented their “REmote SOLutions for Telementoring of pocus-Echocardiography (RESOLUTE)” study at the recent annual meeting of the Society of Cardiovascular Anesthesia in Orlando, Florida, April 22nd-26th.

The primary objective of their study was to determine the feasibility of telementored instruction of cardiac point-of-care ultrasound (POCUS) using Reacts. They sought to investigate whether bedside ICU nurses with no previous sonographic training could be instructed remotely, using Reacts, to obtain five standard cardiac POCUS images on a high-fidelity ultrasound simulator. 33 cardiac surgery intensive care unit (CSICU) nurses with no previous sonography training were recruited to participate in the study. An instructor guided each subject in real time, using Reacts, to obtain sufficient POCUS cardiac views on the ultrasound simulator to determine the underlying pathology. The subject, instructor and reviewing expert were blinded to the diagnosis. Mean instructional time was 2.37 minutes; mean time required to acquire 5 standard TTE views was 3.60 minutes; and mean time required for instructor to guide a subject through a POCUS exam and obtain a diagnosis of underlying pathology was 1.42 minutes. Both reviewers correctly identified 32 out of 33 underlying pathologies.

The study concluded that, guided via Reacts, telementored CSICU nurses with no previous sonography experience were able to acquire sufficient quality POCUS images for basic interpretation both rapidly and consistently. It demonstrated the feasibility of remote instruction of the psychomotor skills necessary to perform point of care cardiac ultrasound by sonography-naive subjects. The study also validated that remote instruction extends the reach of the expert physician not only for instruction, feedback and troubleshooting of POCUS education but also that it could bypass the need for local experts entirely.

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