Sonographers as Teachers of Pediatric Echocardiography: A Cross-Sectional Needs Assessment among Four Academic Pediatric Cardiac Centers

Pediatric cardiac sonographers spend significant time teaching echocardiography. How prepared sonographers are for this crucial role remains unknown. We sought to understand current sonographer knowledge, attitudes, and confidence in teaching pediatric cardiology fellows. This cross-sectional study recruited sonographers and pediatric cardiology fellows at 4 centers by email from Jan-Feb 2025. All subjects provided demographic data and completed a 27-item Interprofessional Attitudes Scale (IPAS), validated to assess healthcare students' cooperative learning beliefs (max score 135). Only sonographers completed a modified 15-item validated Maastricht Clinical Teaching Questionnaire (MCTQ), yielding average ratings (1-5) and teaching ratings (1-10). Open-ended responses were reviewed for recurrent themes. Response rate was 76/124 (61.3%) eligible subjects: 31 fellows and 45 sonographers. Prerequisites for sonographers teaching fellows were skills assessment (42%), certification (39%), time (36%), none (36%), observation (22%), and education-related didactics (11%). IPAS scores [median (IQR)] were available for 29 fellows [116(90-125)] and 35 sonographers [118(93-123)] with no significant difference between groups (p = 0.7). Sonographer MCTQ average ratings were 4.14(3.86-4.50). By Spearman's rank, there was a positive correlation between sonographer MCTQ average rating and time teaching fellows (r = 0.36, p = 0.04) as well as sonographer IPAS (r = 0.44, p = 0.008). Themes from open-ended comments included specialty-specific medical knowledge and technical skills; individualized learning goals and assessment; fostering a positive, supportive learning environment; feedback and communication; time constraints; and general medical education skills. We found that sonographer prerequisites for teaching fellows were inconsistent. Sonographer confidence in teaching was associated with time spent teaching. Updating current pediatric cardiac sonographers on competency-based fellow evaluation is warranted.