The goal of this observational cohort study is to investigate gastric ultrasound skills in surgical nurses. The main question it aims to answer is:

• how much training is required for surgical nurses to obtain competency in performing gastric ultrasound.

Participants will follow a training involving

• theoretical background using e-learning, picture library and lecture
• practical skill development in an interactive hands-on workshop on live models directed by expert gastric ultrasonographer
• and formative assessments during training sessions scanning healthy volunteers by participants and examiners (expert gastric ultrasonographers).

Aims: To determine the amount of training bachelor nurses require to achieve competence in the bedside point-of-care ultrasound technique for qualitative assessment of gastric content.

Study design: prospective cohort educational study

Study population: The participants are six nurses at bachelor level with at least 1 year of experience with surgical patients. Volunteers are healthy persons without a pre-existing abnormal anatomy of the upper gastrointestinal tract.

Main study parameters/endpoints Primary outcome is the number of ultrasound examinations which is required to achieve competence in the performance of ultrasonography qualitative assessment of gastric content. The number of ultrasound assessments nurses need to achieve 90% success rate in 10 consecutive ultrasound assessments among healthy volunteers. Reference test is the ultrasound assessment of examiners experienced in (gastric) ultrasound.

Methods: The education program is developed according to relevant literature, panel discussion of a project group including relevant experts on gastric ultrasonography and nursing education.

Six nurses will follow the education program including didactic teachting and formal assessments. The didactic teaching include1) theoretical background using e-learning, picture library and lecture and 2) practical skill development in an interactive hands-on workshop on live models directed by expert gastric ultrasonographer. Formative assessments will be done by scanning healthy volunteers by participants and examiners (expert gastric ultrasonographers). Volunteers will be asked to adhere to a randomized prandial. Participants and examiners will be blinded for the prandial status of the volunteer.

Analysis: Cumulative sum scores will be estimated to determine the number of trainings that is required.

Inclusion criteria for nurses:

• nurses with at least 1 year experience at the unit;
• nurses with a bachelor's degree in nursing;
• nurses with a particular interest in ultrasonography.
• nurses without previous experience in ultrasonography;

Inclusion criteria for healthy volunteers:

• no history of abnormal anatomy or surgery of the upper gastro-intestinal tract (previous oesophageal-, gastric-, or upper abdomen surgery, or hiatus hernia);
• no diabetes mellitus

Exclusion criteria

• subjects who do not provide written informed consent.

Nurses employed at the gastro-intestinal and oncology department in the Radboudumc who underwent G-POCUS training The training goals are sufficient knowledge, skills, and attitude to achieve sufficient competence. The course will be divided into three components: 1) didactic teaching in an e-learning, study material, and picture library; 2) Interactive session consisting of a hands-on workshop by the expert sonographer and scanning of other trainees; 3) performing G-POCUS in healthy volunteers in a training environment with formal assessment.