Pediatric Residency Point-of-Care Ultrasound Training Needs Assessment and Educational Intervention

Abstract

BackgroundPrior studies showed that point-of-care ultrasound (POCUS) training is not commonly offered in pediatric residency. We assessed the need for a pediatric POCUS curriculum by evaluating pediatric trainees' attitudes toward the use of POCUS and identifying barriers to training. We also aimed to evaluate the impact of a POCUS educational intervention on self-efficacy and behavior. MethodsWe conducted a cross-sectional survey of pediatric residents in a single large freestanding children's hospital distributed via an institutional listserv and administered online. The survey included opinionrating of statements regarding POCUS and barriers to training. We also offered a two-week POCUS course with online modules and hands-on scanning. Participating residents completed pre-and post-course knowledge assessments and follow-up surveys up to 12 months following the course to assess POCUS use and self-report confidence on POCUS indications, acquisition, interpretation, and clinical application. ResultsForty-nine respondents were included in the survey representing all three pediatric levels with 16 specialty interest areas. Ninety-six percent of trainees reported that POCUS is an important skill in pediatrics. Ninety-two percent of trainees reported that residency programs should teach residents how to use POCUS. The most important perceived barriers to POCUS training were scheduling availability for POCUS rotations and lack of access to an ultrasound machine. Fourteen participants completed the pre-and post-course knowledge tests, with eight and six participants also completing the six-and 12-month follow-up surveys, respectively. Self-ratings of confidence were significantly improved post-intervention in indications (P = 0.007), image acquisition (P = 0.002), interpretation (P = 0.002), and clinical application (P = 0.004). This confidence improvement was sustained up to 6-12 months (P = 0.004-0.032). Participants also reported higher categorical POCUS use after course completion (P = 0.031). ConclusionsPediatric trainees perceive POCUS as an important skill, hold favorable opinions towards the use of POCUS, and support POCUS training within a pediatric residency. A POCUS course can improve resident POCUS knowledge, instill confidence, and motivate higher POCUS use. Further study is needed to evaluate POCUS applications in pediatric medicine to develop a standardized POCUS curriculum and establish a training guideline for pediatric residency.

Pediatric Residents’ Perceptions of a Point-of-Care Ultrasound Collaboration With Emergency Medicine

“…The current study suggests that partnerships between pediatrics and emergency medicine may be an effective strategy for teaching POCUS basics to pediatric residents because a lack of qualified educators within pediatrics is reported as a barrier to providing this education [ 7 - 9 ]. While other programs have effectively utilized PEM program faculty to teach POCUS, many pediatric residency programs do not have access to a PEM training program [ 10 , 11 ].…”

“…When surveyed, most pediatric residents believed their residency programs should teach them how to use POCUS [7]. However, many pediatric residencies do not currently teach POCUS, with reported barriers including a lack of an established curriculum and a lack of qualified educators [7][8][9].…”

“…When surveyed, most pediatric residents believed their residency programs should teach them how to use POCUS [7]. However, many pediatric residencies do not currently teach POCUS, with reported barriers including a lack of an established curriculum and a lack of qualified educators [7][8][9]. Some residency programs have begun to address these barriers, including one program that implemented a three-year longitudinal curriculum designed by pediatric emergency medicine (PEM) and POCUS fellowship-trained provider [10].…”

Pediatric ultrasound practice in Italy: an exploratory survey

“…The lack of or inadequate diagnostic imaging equipment is reported as a major barrier for US implementation also in low- and middle-income countries, as underlined in a recent sistematic review [ 11 ]. Definitely, the availability of US equipment and machines throughout various clinical settings should be enhanced, also favoring the use of portable and handheld devices with lower cost but good resolution [ 12 , 13 ].…”

A Longitudinal Evaluation of a Multimodal POCUS Curriculum in Pediatric Residents

“…There is a demonstrated demand for POCUS education to be included in pediatric residencies both from the perspective of program leadership as well as from pediatric trainees. One survey of pediatric residents at a free-standing children’s hospital found that 96% felt that POCUS was an important skill in pediatrics 18 . In a separate survey, pediatrics residents overwhelmingly felt that POCUS training should be required during residency, yet only 15% of respondents had received such training 19 .…”