P3D129: Pocused! Point-of-care Ultrasound Education Through a Multi-disciplinary Curriculum for Neonatology, Pediatric Critical Care, and Pediatric Emergency Medicine Fellows

Background: Point-of-care ultrasound (POCUS) is a non-invasive bedside tool. In adult emergency medicine, POCUS is a required part of residency training. However, pediatrics is slow to adopt this tool due to variability in experience and availability of POCUS experts. Pediatric emergency medicine (PEM) and critical care medicine (PCCM) are leading the way while in neonatology, POCUS training is severely limited by a lack of educators. To overcome these barriers, we implemented a multi-disciplinary POCUS curriculum for fellowship trainees within neonatology (NICU), PCCM, and PEM. We hypothesized that this joint curriculum will allow trainees to learn from faculty with POCUS experience in different fields, provide multi-disciplinary collaboration, and improve trainee confidence in their POCUS skills.

Methods: The yearlong curriculum, taught by faculty from all 3 programs, comprises monthly sessions alternating between didactic lectures and hands-on scanning. Over the year, trainees learn vascular access, lung, eFAST, head/spine, and cardiac. We surveyed the trainee response with pre- and mid-year surveys. At the time of the mid-year survey, only 2 topics were completed. Level of training, familiarity with POCUS, interest in POCUS, and confidence in POCUS skill acquisition, interpretation, and medical decision making (MDM) were assessed. Preliminary descriptive results are presented.

Results: There are 34 fellowship trainees in total, comprised of PGY4-PGY8. The pre-curriculum survey had an 85% response (29/34) with 57% PCCM, 30% NICU, and 13% PEM. The mid-year survey had a 65% response (22/34) with 50% PCCM, 45% NICU, and 5% PEM. Most respondents (67%) had some experience with POCUS from medical school, residency, fellowship, or through a POCUS course. On a 10-point scale, 83% were very interested (>8) in POCUS and 90% felt it would be very useful (>8) in their field. Procedural guidance was identified as the most interested and most useful topic followed by cardiac POCUS. Trainee confidence (on a 5-point scale) prior to the curriculum was evenly distributed for vascular access while for lung, the majority of respondents were initially ‘not confident’ (1) in their skills (48-58%). After teaching sessions, more than 50% of respondents were ‘fairly confident’ (4) or ‘very confident’ (5) in their vascular access skills and more respondents felt ‘fairly confident’ (4) in their lung US skills (47-57%) [Figure 1].

Conclusion: There is incredible interest from trainees to learn POCUS; however, pediatric POCUS education has been limited by the available expertise of the faculty. Our multi-disciplinary curriculum overcomes this problem by utilizing the strengths of faculty in 3 separate divisions to teach our trainees. Furthermore, through monthly didactics with hands-on sessions, trainee confidence in their POCUS skills were increased in the 2 topics surveyed thus far. This increased confidence may help further motivate learners to continue improving their skills and ultimately close the gap in pediatric POCUS education.