Table 2 Round 1 results

General competencies

 Know which probe(s) to use and probe orientation

25/26 (96)*

1/26 (4)

0

 Basic knobology (depth/gain)

26/26 (100)*

0

0

 Appropriate infection prevention and control measures

18/26 (69)

5/26 (19)

2/26 (8)

 Appropriate sheathing of transducers for real-time guidance

20/25 (80)*

2/25 (8)

3/25 (12)

 Recognizes limitations (e.g. when procedure cannot be performed or should be performed by a more experienced proceduralist)

25/26 (96)*

1/26 (4)

0

 Able to correlate findings on ultrasound with surface anatomy

19/26 (73)*

5/26 (19)

2/26 (8)

Thoracentesis

 Can identify the spine sign (e.g. vs. mimickers and false positives of pleural effusion such as drop out artifact)

19/26 (73)*

7/26 (27)

0

 Characterization of pleural effusion (septations/etc.)

18/26 (69)

8/26 (31)

0

 Assessment to include probe sliding/two planes

20/25 (80)*

3/25 (12)

2/25 (8)

 Assessment to include deep breaths (lung movement) and diaphragm movement

14/26 (54)

10/26 (38)

2/26 (8)

 Can identify location of diaphragm/intra-abdominal organs/lung tip

25/26 (96)*

1/26 (4)

0

 Ruling out vasculature (e.g. intercostal vessels)

11/26 (42)

14/26 (54)

1/26 (4)

 Indirect guidance

25/26 (96)*

1/26 (4)

0

 Direct real-time guidance^†

1/26 (4)

8/26 (31)

17/26 (65)

 Assessing for pneumothorax pre- and post-

7/26 (27)

12/26 (46)

7/26 (27)

 Sinusoidal sign

0

5/25 (20)

20/25 (80)*

 Pleural effusion size estimation

1/25 (4)

12/25 (48)

12/25 (48)

Paracentesis

 Can identify abdominal free fluid

25/26 (96)*

1/26 (4)

0

 Assessment to include probe sliding/two planes

18/26 (69)

7/26 (26)

1/26 (4)

 Assessing for location of structures to avoid (liver, spleen, bladder, kidney, bowel)

24/26 (92)*

2/26 (8)

0

 Assessment to include compression to ensure depth of fluid collection remains sufficient

17/26 (65)

8/26 (31)

1/26 (4)

 Ruling out vasculature (e.g. inferior epigastrics/collaterals)

20/26 (77)*

6/26 (23)

0

 Indirect guidance

26/26 (100)*

0

0

 Real time guidance (either in-plane or out-of-plane)^†

1/26 (4)

8/26 (31)

17/26 (65)

 Real-time in-plane guidance

0

4/25 (16)

21/25 (84)*

Real-time out-of-plane guidance

0

4/25 (16)

21/25 (84)*

 Recognizes mimickers of free fluid (e.g. intraluminal fluid, perinephric fat)

22/25 (88%)*

3/25 (12)

0

Central venous catheterization (CVC)

 Can differentiate between artery vs. vein

26/26 (100)*

0

0

 Assessment to include ruling out deep vein thrombosis (in the access site vein, not thrombosis in the legs)

15/26 (58)

10/26 (38)

1/26 (4)

 Identify appropriate insertion site based on anatomy (not just where vein is largest, but if location is too low and at high risk of pneumothorax)

22/26 (85)*

4/26 (15)

0

 Can identify underlying lung (for internal jugular and subclavian sites)

20/26 (77)*

5/26 (19)

1/26 (4)

 Creep technique for all real-time guidance maneuvers

17/25 (68)

7/25 (28)

1/25 (4)

 Real time guidance for internal jugular CVC

24/26 (92)*

2/26 (8)

0

 Internal jugular CVC: either in-plane or out-of-plane

17/25 (68)

7/25 (28)

1/25 (4)

 Internal jugular CVC: in-plane

2/24 (8)

14/24 (58)

8/24 (33)

 Internal jugular CVC: out-of-plane

7/24 (29)

8/24 (33)

9/24 (34)

 Subclavian CVC: real-time guidance

10/25 (40)

9/25 (36)

6/25 (24)

 Subclavian CVC: indirect guidance

4/25 (16)

12/25 (48)

9/25 (36)

 Femoral CVC: real-time guidance

22/26 (85)*

4/26 (15)

0

 Femoral CVC: indirect guidance^†

7/24 (29)

8/24 (33)

9/24 (38)

 Assessment to include confirming location of wire intra-vein with ultrasound

25/26 (96)*

1/26 (4)

0

 Assessment to include confirming catheter is intra-vein with ultrasound

10/26 (38)

11/26 (42)

5/26 (19)

 Assessing for pneumothorax pre- and post-

6/25 (24)

11/25 (44)

5/25 (2)

 Saline flush test

3/26 (12)

10/26 (38)

13/26 (50)

 Assessing for direction of catheter towards superior vena cava

2/26 (8)

7/26 (27)

17/26 (65)

 Performs bicaval view to visualize the catheter tip

1/25 (4)

4/25 (16)

20/25 (80)*