Ultraschall Med 2007; 28 - V_12_3
DOI: 10.1055/s-2007-989098

THOLUUSE: Thorax, trachea and lung ultrasonography in critical care medicine. Evaluation of a new training concept

M Steigerwald 1, TO Hirche 2, S Kujumdshiev 2, M Rudolph 1, S Jungbluth 2, S Jobmann 3, H Ackermann 4, M Oestreicher 5, FH Seeger 6, U Eiden 7, R Breitkreutz 7
  • 1Hospital of the Johann Wolfgang Goethe University, Emergency Ultrasound Working Group, Frankfurt, Germany
  • 2Hospital of the Johann Wolfgang Goethe University, Department of Pneumology, Frankfurt, Germany
  • 3Berufsgenossenschaftliche Unfallklinik, Trauma Surgery, Frankfurt, Germany
  • 4Hospital of the Johann Wolfgang Goethe University, Institute for Bioinformatics and Statistical Analysis, Frankfurt, Germany
  • 5Hospital of the Johann Wolfgang Goethe University, Department of Haematology, Frankfurt, Germany
  • 6Hospital of the Johann Wolfgang Goethe University, Department of Cardiology, Frankfurt, Germany
  • 7Hospital of the Johann Wolfgang Goethe University, Department of Anaesthesiology, Intensive Care, Frankfurt, Germany

Objective: To determine if the THOLUUSE training concept can enhance

1) theoretical knowledge, recognition of thoracic, tracheal and lung (TTL) ultrasound examination (USE),

2) interpretation of physiological and disease related findings regarding pleuaral effusion (PLE) and pneumothorax (PTX) and

3) performance of focused USEs. Many publications proposed that PLE/PTX are easy to detect, but no training-method was available.

Methods: In a prospective, observational and educational study THOLUUSE was tested in a 5-hours program with six distinct lectures in physiology, anatomy, sonoanatomy and pathology and case presentations of TTL. Trainees (n=40) were medical students (14), anaesthesiologists (17), as ultrasound novices and trauma surgeons (9) with previous FAST-ultrasound training. Additionally two 1-hour hands-on-trainings (HOT) were applied using a rotating system, with an instructor to trainee ratio of 1:2. HOT1 included teaching of 12 major artefacts in healthy models. HOT2 contained further training and examination in models or patients and puncture training in a puncture-model. Trainees had to pass pre-and post-course examinations:

1) 20 item multiple choice questionaire,

2) simulation test with 15 movie-clips, and after HOT2,

3) practical post-examination in which they had to demonstrate USE skills in 16 views.

Results:

1) Score of correct MCQ answers changed from 56%±4 to 82%±2* (mean±SEM, *p<10–6, Wilcoxon matched-pairs test).

2) Recognition performance (percent change) of movie-clips was 44%±30** (**p<10–6),

3) Obtaining correct views in the practical post-examination was 94% in n=29 trainees.

Conclusion: THOLUUSE significantly improved theoretical knowledge and USE skills to recognition and interpretation of PLE or PTX related findings.