(1488) Development of Entrustable Professional Activities for Ultrasound in Pediatric Critical Care

Monday, February 24, 2025

9:00am – 10:00am Eastern Time

Location: Connections Central - RST 10

First Author(s)

VB

Vidit Bhargava, MD

University of Alabama at Birmingham, USA

Co-Author(s)

JD

Joshua Davis, MD

Assistant Medical Director, Clinical Instructor
Vituity, Kansas, United States
Michael Lintner-Rivera, MD (he/him/his)

Indiana University School of Medicine, Riley Hospital for Children
Indianapolis, Indiana, USA
SF

Saul Flores, MD, FACC, FCCM

Texas Children's Hosptial
Houston, Texas, USA
IM

Ivanna Makson, MD

Associate Professor of Pediatrics
David Geffen School of Medicine at UCLA, United States
AA

Awni Al-Subu, MD

Associate Professor and Medical Director
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, United States
HC

Harsha Chandnani, MD, MBA, MPH

Associate Professor of Pediatrics
Loma Linda University, United States
GC

Grace Chong, MD

Assistant Professor of Pediatrics
University of Chicago, United States
Sarah Ginsburg, MD

UT Southwestern Medical Center, USA
PG

Peter Gutierrez, MD

Assistant Professor of Pediatrics and Emergency Medicine
Emory University School of Medicine, United States
Bereketeab Haileselassie, MD, MHS

Assistant Professor of Pediatrics (Critical Care)
Stanford School of Medicine
Palo Alto, California, United States
BK

Benjamin W. Kozyak, MD (he/him/his)

Assistant Professor of Clinical Anesthesiology and Critical Care
Children's Hospital of Philadelphia
Philadelphia, PA, United States
Michelle M. Ramirez, MD, FAAP

Assistant Professor of Pediatrics
Hassenfeld Children's Hospital at NYU Langone
Brooklyn, NY, United States
Sandeep Tripathi, MD, MS, FCCM

University of Illinois College of Medicine - Peoria, USA
JW

Jesse Wenger, MD (he/him/his)

Seattle Children's Hospital
Seattle, Washington, USA
PS

Peter Scully, MD

Assistant Professor, Pediatric Critical Care Medicine. Associate Director, Pediatric Critical Care M
McGovern Medical School at UT Health, United States
ST

Satid Thammasitboon, MD

Associate Professor
N/A, United States
EF

Eduardo Fastag-Guttman, MD

Assistant Professor of Pediatrics
University of Minnesota
Minneapolis, Minnesota, United States
BL

Boran Li, MD

Assistant Professor of Pediatrics, Pediatric Critical Care and Cardiology Attending Physician
Mount Sinai Kravis Children's Hospital
New York City, New York, United States
JM

Jennifer MacDonald, MD, PhD (she/her/hers)

Nationwide Children's Hospital, United States

Introduction: POCUS is an increasingly used skill in pediatric critical care medicine, yet there is no consensus on appropriate education on this topic. Thus, we sought to develop a consensus-based framework for pediatric critical care ultrasound (CCUS) education using Entrustable Professional Activities (EPAs).

Methods: An expert panel of 23 members representing 17 institutions, including diverse healthcare professionals involved in pediatric critical care ultrasound, conducted three iterative modified Delphi rounds using virtual meetings and surveys. These experts were members of the Pediatric Research Collaborative on Critical Ultrasound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). EPAs were evaluated using 5-point Likert-type scale, requiring a median score of ≥4.5 for progression.

Results: We obtained a 74% response rate initially and 100% agreement post hoc. Fourteen EPAs across five domains scored ≥4.5 and progressed to final inclusion. Consensus opinion was established on two additional topics: educational content and methods.
Topics covered by basic EPAs included:
Cardiac - hemodynamic instability, cardiac arrest
Pulmonary - respiratory insufficiency
Abdomen - peritoneal free fluid, bladder volume
Procedures - arterial & venous vascular access, drainage of pleura and peritoneum, and lumbar puncture
Educational content - program infrastructure

Advanced topics included cardiac output, valvular function, diaphragmatic function, endotracheal tube positioning, deep vein thrombosis, and supraclavicular central access.

Educational methods supported included periodic assessments/examinations, serial didactics, periodic review of images, bedside educational rounds (including simulation), an introductory dedicated course, learner portfolio, Interdisciplinary education, tiered credentialing, and interdisciplinary learners.

Conclusions: This collaborative effort led to the establishment of fourteen EPAs for pediatric CCUS, offering a structured approach to education and competency assessment in pediatric critical care. This initiative lays the groundwork for evolving pediatric CCUS education and practice standards.