Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation

OBJECTIVES Transesophageal echocardiography (TEE) is being increasingly utilized during orthotopic liver transplantation to guide perioperative management. Obstacles of improving TEE utilization include the challenge of becoming familiar with the TEE machine, optimizing TEE images, and translating s...

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Main Authors: Alexander D. Stoker, Narjeet Khurmi, Marlene E. Girardo, Peter E Frasco
Format: Article
Language:English
Published: SAGE Publishing 2024-02-01
Series:Journal of Medical Education and Curricular Development
Online Access:https://doi.org/10.1177/23821205241228992
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author Alexander D. Stoker
Narjeet Khurmi
Marlene E. Girardo
Peter E Frasco
author_facet Alexander D. Stoker
Narjeet Khurmi
Marlene E. Girardo
Peter E Frasco
author_sort Alexander D. Stoker
collection DOAJ
description OBJECTIVES Transesophageal echocardiography (TEE) is being increasingly utilized during orthotopic liver transplantation to guide perioperative management. Obstacles of improving TEE utilization include the challenge of becoming familiar with the TEE machine, optimizing TEE images, and translating skills acquired in didactic or simulator center-based training into clinical use. METHODS In an effort to expand TEE utilization and improve workflow among the liver transplantation (LT) anesthesiologists at our institution, a LT-specific TEE guide was created to serve as a reference and educational tool during LT. A 26-question survey was distributed to all LT anesthesiologists before and 6 months after implementation of the LT-specific TEE guide. RESULTS All seven LT anesthesiologists completed the survey questions during the study period. No statistically significant difference was detected in participant-reported confidence in optimizing targeted TEE views, performing technical aspects of the exam, navigating the knobs on the TEE machine, or in ability to identify abnormal cardiac pathology during the study period. One participant became basic-TEE certified during the study period. CONCLUSIONS Implementing a liver transplant-specific TEE guide is a strategy to expand TEE utilization, encourage longitudinal TEE education and reinforce concepts learned from hands-on education sessions; however, we did not detect a difference in participant-reported confidence of performing a TEE exam, ability to identify abnormal cardiac pathology or altering workflow. Further studies with larger sample sizes will be needed to evaluate the effectiveness of a LT-specific TEE guide.
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spelling doaj.art-4567110fe6374e15a150858b758d0d8d2024-02-12T07:03:38ZengSAGE PublishingJournal of Medical Education and Curricular Development2382-12052024-02-011110.1177/23821205241228992Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver TransplantationAlexander D. Stoker0Narjeet Khurmi1Marlene E. Girardo2Peter E Frasco3 Mayo Clinic Arizona, Phoenix, AZ, USA Mayo Clinic Arizona, Phoenix, AZ, USA Department of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA Mayo Clinic Arizona, Phoenix, AZ, USAOBJECTIVES Transesophageal echocardiography (TEE) is being increasingly utilized during orthotopic liver transplantation to guide perioperative management. Obstacles of improving TEE utilization include the challenge of becoming familiar with the TEE machine, optimizing TEE images, and translating skills acquired in didactic or simulator center-based training into clinical use. METHODS In an effort to expand TEE utilization and improve workflow among the liver transplantation (LT) anesthesiologists at our institution, a LT-specific TEE guide was created to serve as a reference and educational tool during LT. A 26-question survey was distributed to all LT anesthesiologists before and 6 months after implementation of the LT-specific TEE guide. RESULTS All seven LT anesthesiologists completed the survey questions during the study period. No statistically significant difference was detected in participant-reported confidence in optimizing targeted TEE views, performing technical aspects of the exam, navigating the knobs on the TEE machine, or in ability to identify abnormal cardiac pathology during the study period. One participant became basic-TEE certified during the study period. CONCLUSIONS Implementing a liver transplant-specific TEE guide is a strategy to expand TEE utilization, encourage longitudinal TEE education and reinforce concepts learned from hands-on education sessions; however, we did not detect a difference in participant-reported confidence of performing a TEE exam, ability to identify abnormal cardiac pathology or altering workflow. Further studies with larger sample sizes will be needed to evaluate the effectiveness of a LT-specific TEE guide.https://doi.org/10.1177/23821205241228992
spellingShingle Alexander D. Stoker
Narjeet Khurmi
Marlene E. Girardo
Peter E Frasco
Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
Journal of Medical Education and Curricular Development
title Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
title_full Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
title_fullStr Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
title_full_unstemmed Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
title_short Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
title_sort implementation of a liver transplant specific tee guide to expand tee utilization and improve workflow during orthotopic liver transplantation
url https://doi.org/10.1177/23821205241228992
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