Marcus75

Marcus Peck (@ICUltrasonica), Consultant Intensivist, Frimley Park Hospital, & FICE Chair, discusses the history and growth of FICE and what exciting developments will be coming in the future.  

The first time I saw a heart move I was captivated, and I knew immediately that echocardiography and ultrasound would make a huge impact on intensive care medicine.

Focused cardiac ultrasound adds real diagnostic value at the bedside. It reveals life-threatening diagnoses that are otherwise difficult to detect clinically, such as pericardial collection and right ventricular failure, and I have seen it save many lives, all without input from other specialities or moving a single patient.

Focused intensive care echo (FICE) accreditation was born from knowledge of how powerful this tool can be, and the need to share it.

In 2012, the FICE committee designed a system to make basic echo training as safe, effective, and achievable as possible. We brought together the best educational methods: an e-learning module, a 1-day practical course, a logbook of 50 scans (at least 10 supervised), and a final triggered assessment by a BSE-accredited practitioner.

Since then, FICE has grown from strength to strength, and by 2017 it had enrolled over 1000 and accredited more than 400 individuals, many of whom have become Mentors themselves.

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FICE has grown from strength to strength, and by 2017 it had enrolled over 1000 and accredited more than 400 individuals, many of whom have become Mentors themselves.

Obtaining FICE accreditation within a full-time job is not only possible in a short space of time, but also rewarding, as demonstrated in this blog by Nitin Arora.[1]

National FICE Mentor coverage is good, but not perfect, and our challenge now is to ensure that FICE training becomes deliverable everywhere. We will continue to work with the Faculty of Intensive Care Medicine to make this possible; only then will 24-hour access become a reality.

The FICE process is constantly growing and adapting to the needs of its practitioners. It has produced hundreds of people with FICE accreditation who want to consolidate and progress their skills. However, the knowledge and skills gap between focused and advanced echo accreditation is wide, and this space isn’t without risk.

To guide FICE-accredited practitioners safely in the right direction, we have developed an “Extended-FICE” (“E-FICE”) course, including a more in-depth assessment of ventricular/valvular function and an introduction to Doppler technology. We expect to see a rapid proliferation of these courses nationwide following E-FICE’s launch at the State of the Art Meeting in December 2017.

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To guide FICE-accredited practitioners safely in the right direction, we have developed an “Extended-FICE” (“E-FICE”) course.

Focused ultrasound is here to stay, and we believe that the best way to ensure safe clinical practice is to encourage regular clinical participation, local expert supervision and self-reflection. To support individuals, the FICE committee and I are working on a FICE Reaccreditation process that strikes the right balance between utility and achievability. Please watch this space for details.

Looking back over its first 5 years, FICE has become what it originally set out to become: an accessible national training process, underpinned by strong governance. Looking forward, it must now grow into its full potential by improving deliverability and quality assurance, and reaching out to the units and organisations that can help achieve them. The future is bright.

Acknowledgements:

The FICE committee – Andrew Breen, Nicola Jones, Rob Orme, Conn Russell

[1]  #FiftyScansInFiftyDays – My journey through FICE Accreditation – Dr Nitin Arora

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Are you a clincian who has achieved their FICE Accreditation?  You may be interested in Extended – Fice on 03/12/17. This course to aims to increase understanding of the capabilities and limitations of FICE.

You can find out more and register here.

You can download a flyer here.

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