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Abstract：
With the paucity of high-quality studies on longitudinal basic critical care echocardiography (BCCE) training, expert opinion guidelines have guided BCCE competence educational standards and processes. However, existing guidelines lack precise detail due to methodological flaws during guideline development.
To formulate methodologically robust guidelines on BCCE training using evidence and expert opinion, detailing specific criteria for every step, we conducted a modified Delphi process using the principles of the validated AGREE-II tool. Based on systematic reviews, the following domains were chosen: components of a longitudinal BCCE curriculum; pass-grade criteria for image-acquisition and image-interpretation; and formative/summative assessment and final competence processes.
Between April 2020 and May 2021, a total of 21 BCCE experts participated in four rounds. Rounds 1 and 2 used five web-based questionnaires, including branching-logic software for directed questions to individual panelists. In round 3 (videoconference), the panel finalized the recommendations by vote. During the journal peer-review process, Round 4 was conducted as Web-based questionnaires. Following each round, the agreement threshold for each item was determined as ≥ 80% for item inclusion and ≤ 30% for item exclusion.
Following rounds 1 and 2, agreement was reached on 62 of 114 items. To the 49 unresolved items, 12 additional items were added in round 3, with 56 reaching agreement and five items remaining unresolved. There was agreement that longitudinal BCCE training must include introductory training, mentored formative training, summative assessment for competence, and final cognitive assessment. Items requiring multiple rounds included two-dimensional views, Doppler, cardiac output, M-mode measurement, minimum scan numbers, and pass-grade criteria. Regarding objective criteria for image-acquisition and image-interpretation quality, the panel agreed on maintaining the same criteria for formative and summative assessment, to categorize BCCE findings as major vs minor and a standardized approach to errors, criteria for readiness for summative assessment, and supervisory options.
In conclusion, this expert consensus statement presents comprehensive evidence-based recommendations on longitudinal BCCE training. However, these recommendations require prospective validation.
To formulate methodologically robust guidelines on BCCE training using evidence and expert opinion, detailing specific criteria for every step, we conducted a modified Delphi process using the principles of the validated AGREE-II tool. Based on systematic reviews, the following domains were chosen: components of a longitudinal BCCE curriculum; pass-grade criteria for image-acquisition and image-interpretation; and formative/summative assessment and final competence processes.
Between April 2020 and May 2021, a total of 21 BCCE experts participated in four rounds. Rounds 1 and 2 used five web-based questionnaires, including branching-logic software for directed questions to individual panelists. In round 3 (videoconference), the panel finalized the recommendations by vote. During the journal peer-review process, Round 4 was conducted as Web-based questionnaires. Following each round, the agreement threshold for each item was determined as ≥ 80% for item inclusion and ≤ 30% for item exclusion.
Following rounds 1 and 2, agreement was reached on 62 of 114 items. To the 49 unresolved items, 12 additional items were added in round 3, with 56 reaching agreement and five items remaining unresolved. There was agreement that longitudinal BCCE training must include introductory training, mentored formative training, summative assessment for competence, and final cognitive assessment. Items requiring multiple rounds included two-dimensional views, Doppler, cardiac output, M-mode measurement, minimum scan numbers, and pass-grade criteria. Regarding objective criteria for image-acquisition and image-interpretation quality, the panel agreed on maintaining the same criteria for formative and summative assessment, to categorize BCCE findings as major vs minor and a standardized approach to errors, criteria for readiness for summative assessment, and supervisory options.
In conclusion, this expert consensus statement presents comprehensive evidence-based recommendations on longitudinal BCCE training. However, these recommendations require prospective validation.
摘要：
由于缺乏关于纵向基础重症监护超声心动图（BCCE）培训的高质量研究，专家意见指南指导了BCCE能力教育标准和过程。然而,由于指南制定过程中的方法论缺陷，现有指南缺乏精确的细节。
使用证据和专家意见，制定关于BCCE培训的方法上稳健的指南，详细说明每个步骤的具体标准，我们使用经过验证的AGREE-II工具的原理进行了修改的Delphi过程.根据系统评价，选择了以下领域:纵向BCCE课程的组成部分;图像采集和图像解释的合格等级标准;形成性/总结性评估和最终能力过程.在2020年4月至2021年5月期间，共有21名BCCE专家参加了四轮比赛。第一轮和第二轮使用了五份基于网络的问卷，包括用于向个别小组成员提出问题的分支逻辑软件。在第3轮(视频会议)中，小组以投票方式最终确定了建议。在期刊同行评审过程中，第四轮是作为基于网络的问卷进行的。在每一轮之后，每个项目的一致性阈值确定为项目纳入≥80%,项目排除≤30%.
在第1轮和第2轮之后，就114个项目中的62个达成了协议。对于49个未解决的项目，在第3轮中增加了12个项目，有56个达成协议，还有5个项目尚未解决。达成共识，纵向BCCE培训必须包括入门培训，指导形成性培训，能力总结性评估，和最后的认知评估。需要多轮的项目包括二维视图，多普勒,心输出量,M模式测量，最小扫描次数,和合格等级标准。关于图像采集和图像解释质量的客观标准，小组同意维持形成性和终结性评估的相同标准，将BCCE的发现分为主要和次要，以及标准化的错误方法，准备进行终结性评估的标准，和监督选项。
总之,本专家共识声明提出了关于纵向BCCE培训的全面循证建议.然而,这些建议需要前瞻性验证.
使用证据和专家意见，制定关于BCCE培训的方法上稳健的指南，详细说明每个步骤的具体标准，我们使用经过验证的AGREE-II工具的原理进行了修改的Delphi过程.根据系统评价，选择了以下领域:纵向BCCE课程的组成部分;图像采集和图像解释的合格等级标准;形成性/总结性评估和最终能力过程.在2020年4月至2021年5月期间，共有21名BCCE专家参加了四轮比赛。第一轮和第二轮使用了五份基于网络的问卷，包括用于向个别小组成员提出问题的分支逻辑软件。在第3轮(视频会议)中，小组以投票方式最终确定了建议。在期刊同行评审过程中，第四轮是作为基于网络的问卷进行的。在每一轮之后，每个项目的一致性阈值确定为项目纳入≥80%,项目排除≤30%.
在第1轮和第2轮之后，就114个项目中的62个达成了协议。对于49个未解决的项目，在第3轮中增加了12个项目，有56个达成协议，还有5个项目尚未解决。达成共识，纵向BCCE培训必须包括入门培训，指导形成性培训，能力总结性评估，和最后的认知评估。需要多轮的项目包括二维视图，多普勒,心输出量,M模式测量，最小扫描次数,和合格等级标准。关于图像采集和图像解释质量的客观标准，小组同意维持形成性和终结性评估的相同标准，将BCCE的发现分为主要和次要，以及标准化的错误方法，准备进行终结性评估的标准，和监督选项。
总之,本专家共识声明提出了关于纵向BCCE培训的全面循证建议.然而,这些建议需要前瞻性验证.
