Point-of-Care Ultrasound Education for Pediatric Residents in the Pediatric Intensive Care Unit

Abstract

Introduction: Point-of-care ultrasound (POCUS) is ultrasound performed by the provider at the patient's bedside to answer a specific clinical question. No guidelines exist for teaching POCUS to pediatric residents, and there are currently no pediatric-specific POCUS resources on MedEdPORTAL. To fill this gap, we designed an educational resource to introduce pediatric residents to POCUS during their pediatric intensive care unit (PICU) rotation. Methods: Our POCUS curriculum included content on ultrasound basics, lung ultrasound, and focused cardiac ultrasound. Residents completed a precourse knowledge test at the start of the PICU rotation. Self-study modules were provided to the residents for independent review. During small group, residents performed ultrasound scanning on subjects with normal anatomy. Residents also participated in weekly POCUS rounds to perform supervised ultrasound scanning on PICU patients with known abnormal ultrasound findings. After completion of the PICU rotation, residents competed a postcourse knowledge test and survey. Knowledge test scores were compared to a historical cohort of residents who had completed the PICU rotation but not the POCUS curriculum. Results: Six residents completed the curriculum, and all completed the postcourse knowledge test with significant improvement in test scores compared to a historical cohort. Residents reported increased knowledge of POCUS indications and comfort performing POCUS. All residents rated the smallgroup sessions and POCUS rounds highly. Discussion: Pediatric residents have little POCUS training and perform poorly on POCUS knowledge testing. A basic POCUS curriculum can be instituted during the PICU rotation and improve resident knowledge and comfort with POCUS.

Evaluating a longitudinal point-of-care-ultrasound (POCUS) curriculum for pediatric residents

“…Point-of-care ultrasound (POCUS) is an ideal imaging modality for many reasons including portability, allowing for immediate bedside access, assistance in real time decision making, and procedural accuracy. Many medical specialties use ultrasound in some manner, including anesthesia [1], neonatology [2], internal medicine [3][4][5], family medicine [6,7], critical care medicine [8][9][10], and emergency medicine [11,12].…”

Teaching Seasoned Doctors New Technology: An Intervention to Reduce Barriers and Improve Comfort With Clinical Ultrasound

“…EM physicians have previously identified barriers to CUS utilization, including a lack of confidence and comfort in operating the machine, obtaining images, interpreting images within the core modalities, and documentation of examinations [17][18][19][20]. While there are examples of train-the-trainer, ultrasound workshops in critical care settings, targeted organ pathology, and simulation cases, there is a paucity of CUS educational approaches that specifically address these barriers and target the needs of non-certified practicing EM physicians [21][22][23][24][25].…”

Implementation and assessment of a pediatric point-of-care ultrasound training course in Japan: a pilot study

“…Thanks to its increasing popularity, in 2015 the American College of Emergency Physicians and the American Academy of Pediatrics published a consensus statement on its use [3], and in 2016 a systematic review of POCUS use in pediatric care proposed reporting guidelines for POCUS examinations [4]. Given its popularity, training courses in pediatric POCUS are being implemented worldwide, further corroborating the efficacy of this technique [5][6][7][8][9][10][11][12][13]. However, many of the training courses target specialists such as pediatric intensivists and pediatric cardiologists [7][8][9][10]12], and focus on cardiac and soft tissue US or US-guided nerve block [6,9,11].…”