Introduction Simulators are increasingly used for training in echocardiography. However,
there is no objective method to assess the skills acquired. Our objective was to develop
and test an automated method to assess echocardiography skills. Methods To automate
the image quality evaluation, we expanded our previously developed neonatal echocardiography
simulator to enable recording of images of the 26 standard cuts and process the image
quality. We then compared the automated and visual methods in scoring image quality
of the echocardiograms obtained by 22 trainees. Results Each echocardiographic image
representing a slice of a three-dimensional volume possesses 3 axes (X, Y, and Z)
that correspond to the roll, pitch, and yaw angles of the transducer, respectively.
Therefore, if the placement and orientation of the transducer are correct, the acquired
image represents the appropriate cardiac window with the desired orientation in all
3 axes. The automated system gives a score of 0 if the transducer is not in the appropriate
cardiac window. A score of 1, 2, or 3 is given if the image falls within the range
of one, two, or three angles, respectively. There was no difference in the image quality
score between automated and visual assessment methods (46.0 +/- 13.0 vs 45.1 +/- 14.4,
P = .19). The two methods had excellent correlation (r = .95). The bias and precision
were 0.9 and 8.8, respectively. Conclusions The automated method is comparable to
visual method for assessment of image quality. The automated process allows for instantaneous
feedback and has the potential to standardize assessment of echocardiography skills
of trainees.
