P0504 - Development of a Point-of-Care Ultrasound Educational Milestone for Pediatric Emergency Medicine Fellows

Background: Point-of-Care Ultrasound (POCUS) is an established clinical tool used in general emergency medicine (EM), but is newer to the field of pediatric emergency medicine (PEM). In 2015, the American Academy of Pediatrics issued a policy statement supporting POCUS use by PEM physicians, and consensus educational guidelines for PEM fellowship training were published in 2019. The ACGME has included POCUS as one of 23 milestones for EM, but no such milestone exists for PEM trainees. The objective of our study was to develop a PEM POCUS educational milestone through electronic Delphi methods.

Methods: A project leadership group was formed on the basis of expertise in POCUS, PEM, and medical education. This primary leadership group selected a panel of experts to generate the content for the PEM POCUS milestone. Experts included EM and PEM POCUS experts as well as PEM program directors. During Round 1, suggestions for competencies and milestone items were elicited from panelists. In Rounds 2 and 3, the lists were streamlined through consensus building surveys. Panelists were asked to rate items for inclusion and to provide justification for their choices. Results were fed back to panelists after each round, who were then asked to revise items until responses reached 80% agreement. At the end of Round 3, the leadership group organized results into an educational milestone structure.

Results: Thirty-three panelists participated, with a 100% response rate during each Delphi round. The final PEM POCUS Milestone consisted of three main competencies including ultrasound physics/ knobology, image acquisition, and utilization of POCUS in medical decision making. Subcompetencies have been organized into sequential milestone levels consistent with the ACGME milestone format. A working draft of the milestone is presented in Table 2.

Conclusion: The electronic Delphi panel of experts successfully generated a comprehensive PEM POCUS Milestone for guiding pediatric emergency medicine fellowship education and assessing PEM fellow competency.