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Background  Transesophageal echocardiography (TEE) offers several advantages over  transthoracic  echocardiography (TTE). Despite these advantages, use of TEE by emergency physicians (EPs) remains rare, as no focused TEE protocol for emergency department (ED) use has been defined nor have methods of training been described.    Objective  This study aims to develop a focused TEE examination tailored for the ED and to evaluate TEE skill acquisition and retention by TEE-naïve EPs following a focused 4-h curriculum.    Methods  Academic EPs were invited to participate in a 4-h didactic and simulation-based workshop. The seminar emphasized TEE principles and views obtained from four vantage points. Following the training, participants engaged in an assessment of their abilities to carry out a focused TEE on a high-fidelity simulator. A 6-week follow-up session assessed skill retention.    Results  Fourteen EPs participated in this study. Immediately following the seminar, 14 (100 %;  k  = 1.0) and 10 (71.4 %,  k  = 0.65) successfully obtained an acceptable mid-esophageal four-chamber and mid-esophageal long-axis view. Eleven (78.6 %,  k  = 1.0) participants were able to successfully obtain an acceptable transgastric short-axis view, and 11 (78.6 %,  k  = 1.0) EPs successfully obtained a bicaval view. Twelve participants engaged in a 6-week retention assessment, which revealed acceptable images and inter-rater agreement as follows: mid-esophageal four-chamber, 12 (100 %;  k  = 0.92); mid-esophageal long axis, 12 (100 %,  k  = 0.67); transgastric short-axis, 11 (91.7 %,  k  = 1.0); and bicaval view, 11 (91.7 %,  k  = 1.0).    Conclusion  This study has illustrated that EPs can successfully perform this focused TEE protocol after a 4-h workshop with retention of these skills at 6 weeks.    Electronic supplementary material  The online version of this article (doi:10.1186/s13089-015-0027-3) contains supplementary material, which is available to authorized users.

critical ultrasound journal

Focused transesophageal echocardiography for emergency physicians—description and results from simulation training of a structured four-view examination