Table 2 for Supplementary Material: Proportions of Trainees Who Obtained 0, 1 Or 2 Points

Table 1 for supplemental digital content: Scoring system, as validated in our previous study [5].

Practical skill Score

Introduction of the probe No Problematic Yes /2 TE Long-axis view at 0° Not recorded Not optimal Optimal /2 TE Long-axis view at 120° Not recorded Not optimal Optimal /2 TG Short-axis view at 0° Not recorded Not optimal Optimal /2 TG Short-axis view at 120° Not recorded Not optimal Optimal /2 TE View of the base of the heart at 0° Not recorded Not optimal Optimal /2 TE View of the base of the heart Not recorded Not optimal Optimal /2 at 90° Total /14 Evaluation skill

Mitral regurgitation None Moderate Marked to massive /2 Aortic regurgitation None Moderate Marked to massive /2 Dilatation of right ventricle None Moderate Marked /2 Pericardial effusion None Noncompressive Compressive /2 Variations in diameter of None Minimal Large /2 superior vena cava Total: /10 Technical skill

Intensivist Expert E/A ratio /2 LV FAC (%) /2 Aortic VTI (cm) /2 Pulmonary VTI (cm) /2 Total: / 8 Interpretation skill

LV contractility Normal Moderately decreased Greatly decreased /2 Hypovolemia No Yes /2 RV failure No Yes /2 Wrong or Treatment proposed Right /2 incomplete

Total /8 Final score /40 Table 2 for supplemental digital content: Proportions of trainees who obtained 0, 1 or 2 points for the screened items of each specific skill assessment at M6*.

Practical skill Score Probe insertion Long axis 0° Long Axis Short axis 0° Short axis Great Great 120° 120° vessels vessels 90° 0° 0 0% 0% 0% 0% 0% 0% 0% 1 12% 12% 25% 22% 23% 12% 23% 2 88% 88% 75% 78% 77% 88% 77%

Evaluation skill Mitral Aortic Score RV size Pericardium SVC regurgitation regurgitation 0 5% 0% 0% 0% 5% 1 7% 5% 20% 10% 12% 2 88% 95% 80% 90% 83%

Technical skill

Pulmonary Score E/A LVFAC LVOT VTI

0 13% 12% 7% 5% 1 22% 32% 30% 20% 2 63% 57% 63% 75%

Interpretation skill Score LV contractility Volemia RV failure Treatment 0 13% 10% 7% 15% 1 2 87% 90% 93% 85% *: 0 means that TEE evaluation was inaccurate, 1 not optimal and 2 optimal [see ref (5)]. Abbreviations: SVC: respiratory variations of superior vena cava, E/A: ratio of maximal velocity of mitral E and A waves, LVFAC: left ventricular fractional area change, VTI: velocity time integral of LV outflow tract Doppler velocities.