Quality of neonatal cranial ultrasound interpretation among paediatric and neonatal trainees in the West Metro of Cape Town: A clinical survey

Background. Cranial ultrasound (cUS) is a recommended skill for paediatric and neonatal trainees in South Africa, but there are no national or regional guidelines for training. Objectives. To survey cUS training and knowledge among paediatric and neonatal trainees working in tertiary and regional neonatal units in the West Metro area of Cape Town. Methods. Trainees who had worked at least 1 month in neonatology on the University of Cape Town training platform were sent an online survey. Results. Thirty-one paediatric registrars and five neonatal senior registrars were sent the survey. Responses were received from 26 of the 36 trainees (72%). None had attended a formal cUS course, 18 (69%) had attended a lecture from a neonatologist, and 8 (30%) had attended a formal consultant tutorial. Ten (38%) trainees received initial training from registrars, medical officers, or self-study. Most trainees stated the cUS report should describe anatomy (92%), haemorrhage (81%) and ventricular size (65%). Knowledge of other reporting and procedural aspects varied from 4% to 50%. Correct identification of the major features of images ranged from 12% to 92% but was below 40% in most questions. Trainees with ≥24 months experience were more likely to correctly identify a normal scan (58% v. 14%; p=0.038) and less likely to assign abnormal prognosis (0% v. 43%; p=0.017). Conclusions. There was inadequate and variable cUS training and competency in paediatric and neonatal trainees in our institution. A national standardised programme for training and accreditation of clinician-performed neonatal cUS will address this.