P2A088: Impact of a Structured Onboarding and Education Program on Pediatric Sonographer Professional Advancement

Background: Transthoracic echocardiography is the mainstay of diagnosis and follow up in pediatric congenital heart disease and requires a high level of technical and interpretive expertise of the performing sonographer. In addition to the challenges of mastering a complex skillset, the sonographer workforce is under added pressure due to chronic staff shortages and work-related musculoskeletal injury. The American Society of Echocardiography have released guidelines for the education of the cardiac sonographer; however, no standardized educational curriculum exists. In 2020, we developed a new hire onboarding program comprising of defined and progressive competency milestones, individualized review with sonographer educator and reading physicians and a quantitative process for review of accuracy of reporting. We also instituted a structured continuing sonographer education curriculum. The aims of this study were to ascertain the quality and effectiveness of the current onboarding and continued educational curriculum and to determine if these experiences influence the sonographer’s professional development, job satisfaction, and retention.

Methods: A cross-sectional online survey on onboarding and continued education was developed and distributed to the cardiac sonographers in our laboratory. The survey consisted of both multiple choice rating (Likert scale) and free text answer questions. All data collected was anonymous and analyzed with descriptive statistics.

Results: Survey response rate was 80% (36/45). Most (70%) have been practicing for > 5 years. Fifteen (42%) sonographers trained with the new onboarding curriculum. Majority of sonographers rated their training duration as appropriate (87%), with a positive feeling of preparedness for independent practice afterwards (20% very prepared, 60% prepared). Majority of sonographers rated the frequency (81% just right) and quality (36% excellent, 44% good) of the continued education positively. Figure 1 depicts the rating of effectiveness of the various methodologies used for onboarding and education. Just in time learning and hands on teaching methods were most effective. Physician teaching and feedback was preferred. Overall, most sonographers perceived the advancement of their knowledge base with access to outside education resources such as academic society membership and attending scientific conferences, as well as training in new skills such as 3D echocardiography along with the continued education curriculum as important for their professional growth, job satisfaction, and job retention (Figure 2).

Conclusion: This cross-sectional survey highlights the role of a structured educational curriculum and onboarding process for pediatric cardiac sonographers. Based on these findings, the authors propose that training and education curricula include timely constructive feedback, hands-on bedside training, and case-based learning to ensure high-quality teaching. Physician engagement in teaching is highly valued and should be incorporated into the workflow. Our study also suggests that continued education and learning new skills help to positively influence the sonographer’s attitudes towards professional development, job satisfaction, and retention.