P3D190: Module-based Education for Pediatric Interns: Improvement in Comfort Level in Management of Single Ventricle Congenital Heart Disease

Background: At our institution, pediatric interns are frontline providers on the cardiology service with limited knowledge prior to their rotation in the management and physiology of single ventricle congenital heart disease (SV). There is a need for resident-focused curriculum to fill this gap, given the lack of formal curriculum and resources developed for residents about this topic. This pilot program aims to assess the feasibility and effectiveness of a module-based curriculum in increasing the comfort level of pediatric interns in their understanding of SV and the SV palliative surgeries, using hypoplastic left heart syndrome (HLHS) as an example.

Methods: A 15-minute interactive module focused on the management of SV and the hypoxemic shunt-dependent infant, as well as the SV palliative surgeries was created using the online platform “Genially”. Prior to the start of the rotation, the module was emailed to the interns to ask for completion. Assessment was completed using an anonymous pre/post retrospective survey embedded within the module. This assessment aimed to evaluate if, after completion of the module, pediatric interns felt more comfortable with 1) management of SV patients, 2) management of hypoxemic shunted infants, and with 3) recalling SV palliative surgeries. Comfort level was assessed via Likert scale (1=strongly disagree to 5=strongly agree) and feedback about the module was elicited via qualitative evaluation. Assessment of knowledge was completed as well.

Results: From 8/2022 to 4/2023, 11 of 14 interns who rotated on the cardiology service completed the module. Interns reported feeling more comfortable with the three domains above after module completion, with a statistically significant difference in all areas. The mean reported confidence level increased from 1.1 to 3.6 for both management of SV and management of hypoxemic shunted infants (p-values < 0.01) and increased from 1.7 to 4.3 for confidence in recalling the 3 SV palliative surgeries after module completion (p-value < 0.01). There also was positive feedback on the module with no negative comments about the structure, length, or content. Knowledge was assessed with interactive questions asking interns to input the typical oxygen saturations for the Norwood operation, Glenn operation, Fontan without fenestration, and Fontan with fenestration, as well as to outline the four primary differential diagnoses for the hypoxemic shunted infant.

Conclusion: Overall, this analysis highlighted the feasibility and effectiveness of a pilot version of an interactive, module-based curriculum in improving pediatric interns’ confidence level in caring for SV patients. This pilot program is ongoing with dissemination of the module continuing until 7/2023. Future directions include expansion of the module to other types of SV, beyond HLHS.