The use of echocardiography in intensive care is a developing field. In expert hands echocardiography has proven its utility in diagnosing cardiac pathology, differentiating shock states and in haemodynamic monitoring. However, whether the results obtained by experts can be generalized to trainees or specialists with limited training remains unclear. Further, concerns around training time and cost for intensive care staff have been a factor in limiting the uptake of echocardiography in intensive care.

The investigators aim to assess the diagnostic accuracy of Australian ICU doctors in training after completion of the current minimum training. After completing a structured teaching program and 30 mentored training scans trainees will be assessed on their accuracy with echocardiography. In the research phase trainees will complete a further 40 scans with each one matched with an expect scan. The results from the expert and trainee scans will be compared to determine the trainee's accuracy.

Registrar Inclusion:

• At least 12 month appointment in Epworth Richmond ICU
• Completion of theoretical component of Epworth Richmond ICU echocardiography program
• Completion of 30 echocardiography scans

Registrar Exclusion:

• Previous experience in echocardiography prior to commencing at Epworth Richmond.

Patient Inclusion

• Patient in ICU or CCU
• 18 years or older
• Not likely to be discharged before completion of the scan

Patient Exclusion

• Likely to be discharged within next two hours
• Atrial fibrillation
• Presence of subcostal or intercostal drains or pneumothorax
• Unable to be consented
• Treating intensivist deems inclusion in study not suitable.

Registrar Participants and Patient Participant