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

Piyawat Arichai; Marc Delaney; April Slamowitz; Roberto Rosario; Heather Gordish-Dressman; Sonali Basu; Jeremy Kern; Angela Maxwell; Alyssa Abo

doi:10.7759/cureus.28696

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

Cureus. 2022 Sep 2;14(9):e28696. doi: 10.7759/cureus.28696. eCollection 2022 Sep.

Authors

Piyawat Arichai¹, Marc Delaney¹, April Slamowitz¹, Roberto Rosario¹, Heather Gordish-Dressman², Sonali Basu³, Jeremy Kern⁴, Angela Maxwell⁵, Alyssa Abo⁵

Affiliations

¹ Pediatrics, Children's National Hospital, Washington, USA.
² Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, USA.
³ Pediatric Critical Care Medicine, Children's National Hospital, Washington, USA.
⁴ Hospital Medicine, Children's National Hospital, Washington, USA.
⁵ Pediatric Emergency Medicine, Children's National Hospital, Washington, USA.

Abstract

Background Prior 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. Methods We 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 opinion-rating 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. Results Forty-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). Conclusions Pediatric 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.

Keywords: attitude; barrier; curriculum; education; knowledge; needs assessment; pediatric; pediatric residency; point-of-care ultrasound; retention.