Abstract
Simulator-based workflow training in echocardiography appears to be gravely lacking. Workflow, or the technical and logistical steps taken to safely and efficiently execute an ultrasound procedure, is an aspect of echocardiography nearly equivalent in importance to performing the procedure itself. A knowledge gap in workflow presently exists between trainees and senior staff; this knowledge gap stems from the fact that workflow education usually is obtained "on the job" through extended repetition. Indeed, the designers of current echocardiographic simulators have gone leaps and bounds to simulate echocardiographic procedures, but none presently allows for workflow training. In this review, the authors describe a proficiency-based educational model for echocardiography, specifically highlighting transesophageal echocardiography, and briefly discuss its design. In addition, the review describes a simulator that when used in combination with formal didactics could provide echocardiographic workflow training.