Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-19T07:20:23.806Z Has data issue: false hasContentIssue false
  • English
  • Français

Does high-variation training facilitate transfer of training in paediatric transthoracic echocardiography?

Published online by Cambridge University Press:  10 December 2020

Colin J. McMahon Open the ORCID record for Colin J. McMahon [Opens in a new window] ,
Sarah Gallagher ,
Adam James ,
Aoife Deery ,
Mark Rhodes  and
Jeroen J. G. van Merriënboer
Colin J. McMahon*
Affiliation:
Department of Paediatric Cardiology, Children’s Health Ireland, Crumlin, Dublin 12, Ireland
Sarah Gallagher
Affiliation:
Department of Paediatric Cardiology, Children’s Health Ireland, Crumlin, Dublin 12, Ireland
Adam James
Affiliation:
Department of Paediatric Cardiology, Children’s Health Ireland, Crumlin, Dublin 12, Ireland
Aoife Deery
Affiliation:
Department of Paediatric Cardiology, Children’s Health Ireland, Crumlin, Dublin 12, Ireland
Mark Rhodes
Affiliation:
Department of Economics, Leeds Beckett University, Leeds, England
Jeroen J. G. van Merriënboer
Affiliation:
Maastricht School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
*
Author for correspondence: Dr. Colin McMahon, Department of Paediatric Cardiology, Children’s Health Ireland, Crumlin, Dublin 12, Ireland. Tel: 01-4096160; Fax: 01-4096181. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Factors that facilitate transfer of training in paediatric echocardiography remain poorly understood. This study assessed whether high-variation training facilitated successful transfer in paediatric echocardiography.

Methods:

A mixed-methods study of transfer of technical and interpretive skill application amongst postgraduate trainees. Trainees were randomised to a low or high-variation training group. After a period of 8 weeks intensive echocardiography training, we video-recorded how trainees completed an echocardiogram in a complex cardiac lesion not previously encountered. Blinded quantitative analysis and scoring of trainee performance (echocardiogram performance, report, and technical proficiency) were performed using a validated assessment tool by a blinded cardiologist and senior cardiac physiologist. Qualitative interviews of the trainees were recorded to ascertain trainee experiences during the training and transfer process.

Results:

Sixteen trainees were enrolled in the study. For the cumulative score for all three components tested (echocardiogram performance, report, and technical proficiency), χ2 = 8.223, p = .016, which showed the high-variation group outperformed the low-variation group. Two common themes which assisted in the transfer emerged from interviews are as follows: (1) use of strategies described in variation theory to describe abnormal hearts, (2) the use of formative live feedback from trainers during hands-on training.

Conclusion:

Training strategies exposing trainees to high-variation training may aid transfer of paediatric echocardiography skills.

Keywords

Echocardiographyeducationvariationskillstrainingtransfer
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 602 - 608
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This work was completed as part of a Masters of Health Professions Education at Maastricht University, the Netherlands.

References

Grossman, R, Salas, E. The transfer of training: what really matters? Int J Train Dev 2015; 15: 103–120.CrossRefGoogle Scholar
Salas, E, Stagl, KC. Design training Systematically and Follow the Science of Training. In Locke, E (ed.). Handbook of Principles of Organisational Behaviour: Indispensible Knowledge for Evidence-based Management, 2nd edn. Wiley & Sons, Ltd., Chicester, West Sussex, United Kingdom, 2009.Google Scholar
Henry, WL, DeMaria, A, Gramiak, R et al. Report of the American Society of Echocardiography committee on nomenclature and standards in two-dimensional echocardiography. Circulation 1980; 62: 212–215. PMID: 7397962.CrossRefGoogle ScholarPubMed
Rychik, J, Ayres, N, Cunco, B et al. American Society of Echocardiography guidelines and standards for performance of the fetal echocardiogram. J Am Soc Echocardiogr 2004; 17: 803–810. DOI: 10.1016/j.echo.2004.04.011 CrossRefGoogle ScholarPubMed
Ayres, N, Miller-Hance, W, Fyfe, DA et al. Indications and guidelines for performance of transesophageal echocardiography in the patient with acquired or congenital heart disease. J Am Soc Echocardiogr 2005; 18: 91–98. doi: 10.1016/j.echo.2004.11.004 CrossRefGoogle ScholarPubMed
Shanewise, J, Cheung, A, Aronson, S, et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography council for intraoperative echocardiography and the Society of Cardiovascular Anesthesiologists task force for certification in perioperative transesophageal echocardiography. J Am Soc Echocardiogr 1999; 12: 884–900. PMID: 10512257CrossRefGoogle Scholar
Lai, WW, Geva, T, Shirali, GS et al. Guidelines and Standards for Performance of a Pediatric echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006; 19: 1413–1430. DOI: 10.1016/j.echo.2006.09.001 CrossRefGoogle ScholarPubMed
van Merriënboer, JJG. Training Complex Cognitive Skills: A Four Component Instructional Design Model for Technical Training. Educational Technology Publications, Eaglewood Cliffs, NJ, 1997.Google Scholar
Baldwin, TT, Ford, JK. Transfer of training: a review and directions for future research. Pers Psychol 1998; 41: 63–105. doi: 10.1111/j.1744-6570.1988.tb00632.x.CrossRefGoogle Scholar
Ceresnak, SR, Axelrod, DM, Sacks, LD et al. Advances in pediatric cardiology boot camp training promotes fellowship readiness and enables retention of knowledge. Pediatr Cardiol 2017; 38: 631–640. doi: 10.1007/s00246-016-1560-y.CrossRefGoogle ScholarPubMed
Skinner, AA, Freeman, RV, Sheehan, FH. Quantitative Feedback Facilitates Acquisition of Skills in Focused Cardiac Ultrasound. Simul Healthc 2016; 11: 134–138. doi: 10.1097/SIH.0000000000000132.CrossRefGoogle ScholarPubMed
Maskatia, SA, Altman, CA, Morris, SA, Cabrera, AG. The echocardiography “boot camp”: a novel approach in pediatric cardiovascular imaging education. J Am Soc Echocardiogr 2013; 26: 1187–1192. doi: 10.1016/j.echo.2013.06.001.CrossRefGoogle ScholarPubMed
Benavides, OJ, Gauvreau, K, Jenkins, KJ, Geva, T. Diagnostic errors in pediatric echocardiography; development of taxonomy and identification of risk factors. Circulation 2008; 117: 2995–3001. doi: 10.1161/CIRCULATIONAHA.107.758532.CrossRefGoogle Scholar
Levine, JC, Geva, T, Brown, DW. Competency Testing for Paediatric Cardiology Fellows Learning Transthoracic Echocardiography: Implementation, Fellow Experience and Lessons Learned. Pediatr Cardiol 2015; 36: 1700–1711. doi: 10.1007/s00246-015-1220-7.CrossRefGoogle ScholarPubMed
Marton, F, Booth, S. Learning and Awareness. Lawrence Erlbaum Associates, New Jersey, 1997.Google Scholar
Marton, F, Tsui, ABM. Classroom Discourse and the Space of Learning. Lawrence Erlbaum Associates, Mahwah, NJ, 2004.CrossRefGoogle Scholar
Creswell, JW. Research Design. Qualitative, Quantitative, and Mixed Method Approaches, 4th edn. Sage, Thousand Oaks, CA, 2014.Google Scholar
Kok, EM. Developing Visual Expertise. From Shades of Grey to Diagnostic Reasoning in Radiology. PhD Thesis, 2016.Google Scholar
Paas, F, van Merriënboer, JJG. Variability of worked examples and transfer of geometrical problem-solving skills: a cognitive-load approach. J Educ Psychol 1994; 86: 122–133. https://doi.org/10.1037/0022-0663.86.1.122.CrossRefGoogle Scholar
Kossaify, A, Grollier, G. Echocardiography Practice: Insights into Appropriate Clinical Use, Technical Competence and Quality Improvement Program. Clin Med Insights Cardiol 2014; 8: 1–7. doi: 10. 4137/C MC. S136 45.CrossRefGoogle ScholarPubMed
Nair, P, Siu, SC, Sloggett, CE, et al. The assessment of technical and interpretive proficiency in echocardiography. J Am Soc Echocardiogr 2006; 19: 924–931.CrossRefGoogle Scholar
Swanepoel, H, DeBeer, F. Community Development. Breaking the Cycle of Poverty. 4th ed. Planning and Presenting a Training Workshop. Juta and Co. Ltd, 2006.Google Scholar
Jaarsma, T, Boshuizen, HPA, Jarodska, H, van Merriënboer, JJG. To guide or to follow? Teaching problem solving at the workplace. Adv Health Sci Educ 2008; 23: 961–976. doi: 10.1007/s10459-018-9842-1.CrossRefGoogle Scholar
Ericsson, KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004; 79: S70–S81.CrossRefGoogle Scholar
Cheng, EWL. Learning through the variation theory: a case study. Int J Teach Learn High Educ 2016; 28: 283–292.Google Scholar
Wopereis, IGJH, Stoyanov, S, Kirchener, PA, Van Merrienboer, JJG. What Makes a Good Musical Improviser? An Expert View on Improvisational Expertise. Psychomusicol Music Mind Brain 2013; 23: 222–235.CrossRefGoogle Scholar
Epstein, DE. Range. How Generalists Triumph in a Specialised World. Roger v. Tiger p 1–15, 2009. Macmillan.Google Scholar