P0372 - A Competency Based Approach to Pediatric Cardiology Echocardiogram Education

Background: The first year of pediatric cardiology fellowship is a year of immense learning with the need for rapid attainment of knowledge. One of the most important skills attained is echocardiography, which includes learning how to scan and interpret echocardiograms. With the vast number of congenital heart lesions, it is important for first year fellows to have exposure to a large number and variety of cases.

Methods: All echocardiograms performed by first year pediatric cardiology fellows from July 2016- July 2019 were included in this study. Changes to the echocardiography curriculum occurred in July 2018 including a boot camp, scheduled sonography teaching and weekly goals/expectations outlined. Nine fellows were included during this period and echocardiograms performed were organized into twenty-seven categories based on lesion and level of complexity. A t-test analysis was done to assess for any changes in number of echocardiograms performed per lesion or complexity during the 2016 – 2017 period compared to 2018. Descriptive statistics were used to observe if there was any improvement in diversity of lesions scanned per class.

Results: A total of 1,362 echocardiograms were analyzed for this study. Each first year fellow class 2016, 2017 and 2018 were compared looking for a significant difference between number of lesions scanned. There was a statistically significant difference in the percentage of lesions scanned between the class of 2016 and 2018 (mean 30.2% vs 41.2%, p = 0.014) as well as between class 2017 to 2018 (mean 28.7%% vs 41.2%, p = 0.002). There was no statistical difference between the class of 2016 and 2017. There was a significant increase in percentage of individual lesions scanned from 2016 to 2017 (81% compared to 89%) but no difference in 2018 (89%).

Conclusion: Introducing a boot camp, along with specific sonographer educators with weekly goal setting, did increase total number of echocardiograms performed as well as overall individual lesions scanned. Despite the total increase in number of echocardiograms performed by first year fellow the overall exposure to different lesions did not increase. Further work will focus on more specific curriculum to ensure both continued increase in overall echocardiograms performed, as well as diversity of lesions scanned to continue to improve fellow echocardiography education.