Transesophageal Echocardiography (TEE) Workshops now offered

MTSA now offers advanced Transesophageal Echocardiography (TEE) training for CRNAs using ultrasound and state-of-the-art HeartWorks simulators. According to instructor John Shields, DNP, CRNA, all participants will perform basic and comprehensive TEE, including image acquisition, cardiac structure identification and pathology recognition.

Upcoming TEE Workshops:

Nov. 15, 2020
Jan. 24, 2021
April 18, 2021

The daylong workshops incorporate the HeartWorks TEE Simulator, a solution for developing cognitive and psychomotor skills for TEE. Users see real-time, seamless ultrasound imaging in synchronization with their movement of the TEE probe, providing a realistic and accurate training experience in preparation for real patient examinations.

Shields said 20 pathologies, including aortic stenosis, mitral regurgitation, biventricular dysfunction and cardiac tamponade, are featured in the training, along with interventional use for transcatheter procedures.

“Ultrasound allows us to see the structures of the heart, the size, whether the heart valve is working efficiently, among other assessments,” Shields said. “We can look at different pathologies of the heart, such as the direction of blood flow, or whether there’s a septal defect. It’s used mainly for cardiopulmonary instability, blood pressure problems, and trouble with oxygenation and saturation.”

Shields points to the fact that TEE has become the standard of care for cardiac surgery, helping to guide the surgeon’s interventions. “CRNAs that practice in cardiac don’t necessarily do TEE because the skill set hasn’t been needed. But we’re leading the way with this state-of-the-art training to expand our scope of practice where it can be utilized. We believe that if you’re not practicing with ultrasound in the next five years, you’ll be way behind. With this training, you’ll be ahead of the curve,” he said.

“Other training programs will do hands-on ultrasound on human models, but you don’t have the ability to assess real pathologies. With a simulator you can. You have every possible pathology that you’re going to find in a real patient, and that’s one of the biggest differentiators of our TEE workshops at MTSA,” Shields added.

Each participant in the workshop will be enrolled in a free 12-chapter TEE course offered by HeartWorks eLearn prior to attending. Online videos and materials will also be made available immediately prior to the workshop.

“It can be intimidating at first, but these workshops are for any CRNA at any experience level – even if they’ve never touched an ultrasound before. The first hour covers the basics, the second hour is application of the basic view and doing certain measurements. After that, we delve into more advanced techniques that will significantly improve their practical skills and give the surgeon what they need,” Shields said.

The program has been prior approved by the American Association of Nurse Anesthetists for 10 Class A credits.

For more information, visit, or contact John Shields at (615) 517-6152,; or

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