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Sustained improvement in fellows’ echocardiographic completeness through the coronavirus pandemic with a standardised imaging protocol

Part of: Echocardiography

Published online by Cambridge University Press:  08 February 2022

Brian R. White Open the ORCID record for Brian R. White [Opens in a new window] ,
Kasey J. Chaszczewski ,
Bethan Lemley ,
Shobha S. Natarajan  and
Lindsay S. Rogers
Brian R. White*
Affiliation:
Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
Kasey J. Chaszczewski
Affiliation:
Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Wisconsin, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USA
Bethan Lemley
Affiliation:
Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
Shobha S. Natarajan
Affiliation:
Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
Lindsay S. Rogers
Affiliation:
Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
*
Author for correspondence: B. R. White, Division of Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3401 Civic Center Blvd., Pediatric Cardiology – 8NW, Philadelphia, PA, 19104, USA. Tel: 215-590-3548; Fax: 215-590-5825. E-mail: whiteb1@chop.edu
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Abstract

First-year cardiology fellows must quickly learn basic competency in echocardiography during fellowship orientation. This educational process was disrupted in 2020 due to the coronavirus pandemic, as our hands-on echocardiography teaching transitioned from practice on paediatric volunteers to simulation-based training. We previously described an improvement in echocardiographic completeness after implementation of a standardised imaging protocol for the performance of acute assessments of ventricular function. Herein, we assessed whether this improvement could be sustained over the two subsequent years, including the fellowship year affected by the pandemic. Echocardiograms performed by first-year paediatric cardiology fellows to assess ventricular function were reviewed for completeness. The frequency with which each requested component was included was measured. A total demographic score (out of 7) and total imaging score (out of 23) were calculated. The pre-protocol years (2015–2017) were compared to the post-protocol years (2018–2020), and the pre-COVID years (2018–2019) were compared to the year affected by COVID (2020). There was a sustained improvement in completeness after protocol implementation with improvement in the demographic score (median increasing from 6 to 7, p < 0.001) and imaging score (median increasing from 13 to 16, p < 0.001). More individual components showed a statistically significant increase in frequency compared to our prior publication. The COVID pandemic resulted in very few differences in completeness. Demographic reporting improved modestly (p = 0.04); the imaging score was unchanged (p = 0.59). The only view obtained less frequently was the apical two-chamber view. A standardised imaging protocol allowed sustained improvements in echocardiographic completeness despite the disruption of fellowship orientation by COVID-19.

Keywords

Quality improvementpaediatric echocardiographyeducationfellowship trainingCOVID-19simulation
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 1 , January 2023 , pp. 69 - 75
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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