The effect of short-course point-of-care echocardiography training on the performance of medical interns in children

Abstract

Background Point-of-care ultrasound (POCUS) can add complementary information to physical examination. Despite its development in several medical specialties, there is a lack of similar studies on children by medical interns and cardiologists. Therefore, investigators aimed to assess the effect of short-course training on the performance of medical interns in point-of-care echocardiography in children. Methods This analytic cross-sectional study was conducted on 161 hospitalized children in 17 Shahrivar children’s hospital, Iran, from January 2021 to May 2021. Seven interns (trainees) participated in a short course of point-of-care echocardiography to assess left ventricular ejection fraction (LVEF), inferior vena cava collapsibility index (IVCCI), and the presence of pericardial effusion (PEff). Each patient underwent point-of-care echocardiography by one of the trainees. Then, in less than one hour, the echocardiography was performed by a single cardiologist. Agreement between the cardiologist and trainees was examined using Cohen’s kappa coefficient and Prevalence-Adjusted Bias-Adjusted Kappa (PABAK). For numerical variables, the agreement was examined using the concordance correlation coefficient (CCC) and intraclass correlation coefficient (ICC). Results Results showed that the cardiologist and trainees detected LVEF >50, IVCCI >50%, and the absence of PEff in most of the participants. A good agreement in terms of ICC and CCC for LVEF (0.832 and 0.831, respectively) and a good agreement in terms of ICC and CCC for IVCCI (0.878 and 0.877, respectively) were noted. Using categorical scoring of LVEF and IVCCI showed 94.4% and 87.6% complete agreement, respectively. Furthermore, using categorical scoring of LVEF and IVCCI, Cohen’s kappa coefficient was 0.542 (moderate) and 0.619 (substantial), respectively. The PABAK for LVEF and IVCCI were 0.886 (almost perfect) and 0.752 (substantial), respectively. For PEff, Cohen’s kappa and PABAK were 0.797 (moderate) and 0.988 (almost perfect), respectively, and the complete agreement was noted in 160 patients (99.4%). Conclusions This study showed that a short teaching course could help medical interns to assess LVEF, IVCCI, and PEff in children. Therefore, it seems that adding this course to medical interns’ curricula can be promising.