704 - Assessing Efficacy of a Flipped Classroom, Simulation-Based, Ultrasound Curriculum for Pediatric Residents

Publication Number: 3681.704

Nithin Ravi, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States; Peter Alsharif, denver health, DENVER, CO, United States; Genie Roosevelt, University of Colorado School of Medicine, Denver, CO, United States; Amanda G. Toney, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO, United States

Background: Standardized POCUS education for pediatric residents lags behind other fields, even though the application is more useful for pediatric patients compared to adults.

Objective: To evaluate the efficacy of a novel, flipped classroom, simulation-based, longitudinal curriculum for pediatric residents, in improving POCUS knowledge, image acquisition, and image interpretation skills.

Design/Methods: This was a prospective single-center observational study. All 39 pediatric interns were auto-enrolled in this course. The course consisted of 3 total sessions per intern from September 2024 to June 2025: (1) skin and soft tissue and E-FAST cases, (2) respiratory distress and shock cases, and (3) live scanning in an urban emergency department. Prior to sessions 1 and 2, the residents were asked to complete 6 web-based POCUS courses. Our primary analysis included pre and post testing for (1) written tests to assess POCUS fund of knowledge, and (2) lung objective structured clinical examination (OSCE) to assess image acquisition and interpretation. The paired t was used to compare the change from PreCourse to PostCourse tests and OSCEs. Mean differences including 95% confidence intervals (CI) are provided for two group comparisons. Secondary analysis focused on self-reported survey responses for comfort with POCUS applications as well as how effective the course was. The Wilcoxon Signed Rank Test was used to compare the change in Likert scales from PreCourse to PostCourse.

Results: The final sample size was 19 after excluding students who missed any of the three sessions. Participants demonstrated significant improvement on the 26 question written test with an aggregate score of 48% (44-52%) on the pretest and 63% (57-69%) on the posttest, a 15% improvement (8-22%, p< 0.001). Participants also showed significant improvement in content area subscores of skin and soft tissue, E-FAST, and RUSH. Participants had significant improvement in the 30 point lung OSCE exam with an average score of 39% before the course (29-49%) and 88% after the course (83-93%), a 49% improvement (39-61%, p< 0.001). Participants had significant improvement in self-reported comfort with performing POCUS exams (95CI: 1.5 to 2.5 categorical improvement, p < 0.001), and 16/19 (84.2%) participants rated the course as “very effective” or “moderately effective”.

Conclusion(s): A flipped classroom, simulation based, longitudinal POCUS curriculum was effective in improving participants' fund of knowledge, image acquisition, interpretation, and integration into clinical decision making, while also improving comfort with different POCUS applications.

Figure 1: Written and OSCE Exam Performance
Figure 1.pdf

Figure 2: Comfort in POCUS Skills
Figure 2.pdf