As perioperative care grows more complex, anesthesiologists are increasingly expected to interpret medical imaging at the point of care. Familiarity with chest radiographs, point-of-care ultrasound (POCUS), transthoracic and transesophageal echocardiography (TTE/TEE), and ultrasound-guided regional anatomy has transitioned from a desirable skill to an essential competency. Training programs for anesthesiologists must therefore integrate structured curricula, assessment, and supervised clinical experience on how to read medical imaging scans in order to ensure safe, high-quality perioperative decision making.

Historically, anesthesiologists relied on radiology and cardiology colleagues for formal reads. Studies from the early 2000s demonstrated persistent gaps in chest radiograph interpretation among practicing anesthesiologists, which spurred calls for targeted education. Contemporary training recognizes those gaps and emphasizes active learning modalities. Didactic lectures remain useful for core principles, but hands-on supervised scanning, iterative image review, and simulation markedly accelerate skill acquisition and retention.

POCUS has become a central pillar of perioperative assessment because it delivers rapid, actionable information about cardiac function, intravascular volume status, lung pathology (including pneumothorax and pleural effusion), and basic abdominal findings. Successful curricular models reported in the literature combine online modules, image libraries, live scanning on standardized patients or models, supervised bedside examinations, and a competency portfolio or logbook. Programs that invest in faculty “train-the-trainer” initiatives and provide scheduled scanning sessions show better trainee outcomes. However, practical challenges include faculty development, device access, and protected educational time.

Cardiac imaging demands higher levels of training and quality assurance. TTE and TEE training are guided by society statements that define essential views, minimum case experience, and objective assessment strategies. Given its procedural risks and diagnostic complexity, perioperative TEE requires formal instruction, mentored case experience, and periodic competency reassessment. Consensus statements and practice guidelines provide standardized image protocols that programs can adopt to create staged progression from basic interpretation to independent performance.

Ultrasound-guided regional anesthesia is another domain where accurate reads of medical imaging directly affect anesthesiologists’ procedural success and patient safety. Simulation and task-trainer workshops build needle-eye coordination, sonoanatomy recognition, and crisis management skills for rare complications. Systematic reviews show that simulation-enhanced training improves knowledge and psychomotor skill acquisition compared with didactic methods alone and may translate to improved clinical performance when coupled with supervised clinical exposure.

Effective curricula share several common elements: clearly defined learning objectives mapped to milestones, multimodal instruction (didactic, imaging libraries, simulation, and bedside teaching), objective assessments (OSCEs or image-review examinations), documented procedural logs, faculty development programs, and continuous quality improvement through routine image archiving with feedback. Interprofessional collaboration with radiology and cardiology accelerates faculty upskilling and establishes reliable escalation pathways for diagnostic uncertainty.

When it comes to improving anesthesiologist skills in the realm of medical imaging, key barriers—such as limited faculty expertise, variability in case exposure, and competing clinical demands—remain. Practical solutions include faculty train-the-trainer models, regional scanning fellowships, protected educational time, and obligatory minimum numbers of supervised scans or TEE cases prior to independent practice. Adoption of standardized POCUS curricula across accreditation bodies and the incorporation of objective structured assessments will further solidify medical imaging interpretation as a core competency for anesthesiologists. Adopting these principles will ensure anesthesiologists remain prepared to interpret perioperative imaging confidently and accurately for patients.

References

1. American Society of Anesthesiologists; Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Practice guidelines for perioperative transesophageal echocardiography. Anesthesiology. 2010;112(5):1084-1096. DOI: 10.1097/ALN.0b013e3181c51e90
2. Reeves ST, Finley AC, Skubas NJ, Swaminathan M, Whitley WS, Glas KE, et al. Basic perioperative transesophageal echocardiography examination: a consensus statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013;26(5):443-456. DOI: 10.1016/j.echo.2013.02.015
3. Lee SC, Yang EC, Navarro JC, et al. An introductory point-of-care ultrasound curriculum for an anesthesiology residency program. MedEdPORTAL. 2022;18:11291. DOI: 10.15766/mep_2374-8265.11291
4. Chen XX, Trivedi V, AlSaflan AH, Todd SC, Tricco AC, McCartney CJL, Boet S. Ultrasound-guided regional anesthesia simulation training: a systematic review. Reg Anesth Pain Med. 2017;42(6):741-750. DOI: 10.1097/AAP.0000000000000639
5. Kaufman B, Dhar P, O’Neill DK, et al. Chest radiograph interpretation skills of anesthesiologists. J Cardiothorac Vasc Anesth. 2001;15(6):680-683. DOI: 10.1053/jcan.2001.28307

Related posts:

Halothane: Biological Mechanisms, Surgical Applications and Side Effects Quality Improvement in Anesthesiology Opioid Associated Postoperative Nausea Mask Induction vs. Intravenous Induction for Anesthesia