A Simulation-based Mastery Learning Curriculum to Address Cardiac Point-of-care Ultrasound Requirements of Anesthesiology Board Certification.

BACKGROUND

Focused cardiac ultrasound (FoCUS) is increasingly recognized as an essential competency for anesthesiologists and appears in the American Board of Anesthesiology (ABA) APPLIED exam. Standardized training approaches remain limited. This study evaluated a simulation-based mastery learning (SBML) curriculum for achieving FoCUS image acquisition competency among anesthesiology fellows and attending anesthesiologists.

METHODS

In this single-center, pretest/posttest study (August 2022-February 2024), 12 fellows and 6 attending anesthesiologists participated in a curriculum consisting of 2 3-hour sessions combining transthoracic echocardiography (TTE) simulation and standardized patient scanning. Performance was assessed using a 20-item checklist derived from the ABA objective structured clinical examination (OSCE) content outline. A minimum passing standard (MPS) of 85% was set using the Mastery Angoff method. Posttests were administered ≥1 month after training. The primary outcome was improvement in FoCUS image acquisition skills, defined by achievement of the MPS on posttest assessment. Secondary outcomes included FoCUS knowledge on a written exam, confidence, course satisfaction, and OSCE success.

RESULTS

Eighteen participants completed the curriculum. At baseline, 0/18 (0%) participants achieved the MPS. Among participants who completed both scheduled training sessions (15/18), 12 (80%) achieved mastery on their first posttest attempt, including all fellows who completed both sessions (9/9). The remaining participants required additional deliberate practice before achieving the MPS on a subsequent posttest. Performance improved significantly across all TTE views (p < .01).

CONCLUSION

This SBML curriculum enabled rapid mastery of FoCUS image acquisition across learners with varying experience levels and achieved competency aligned with expectations for FoCUS image acquisition on the ABA APPLIED examination. SBML can be utilized to create effective curricula addressing evolving certification requirements and clinical needs.