Pediatric Cardiology Echocardiography Curriculum and Workshop for Pediatric Residents in Mwanza, Tanzania-Using Deliberate Practice for Skill Acquisition

Bugando Medical Center (BMC) in Mwanza, Tanzania, with two hundred pediatric beds, has a large burden of pediatric heart disease. The general pediatric residents are front-line cardiology providers. At the time of this study, there was a single pediatrician with echocardiography training, performing all echocardiograms and providing trainee education, teaching residents on-the-job with limited access to continued education. Our aim was to build pediatric residents' cardiac ultrasound capacity at BMC through asynchronous learning and a hands-on workshop. The target learner group was BMC pediatric residents participating in a pediatric echocardiographic workshop. Baseline data was collected through a comfort survey, knowledge test, and skills test in acquisition/interpretation of echocardiographic images. An in-person, five-day workshop was conducted for acquisition of basic 2-dimensional images and recognizing abnormal images. At the end of the workshop, learners completed a knowledge post-test, an assessment of normal vs. abnormal images, and a skills test to determine ability to obtain standard images. 29 pediatric residents (15 PGY-2, 13 PGY-3, 1 registrar) participated in the workshop. The percentage of trainees who felt comfortable using an echocardiography machine increased from 60% to 96%. Knowledge test scores increased from 58% (n = 28) to 84% (n = 25) after intervention (p < 0.001). Skills assessment exhibited a significant improvement, from 10% to 83% of trainees' ability to acquire images from all five imaging planes. Trainees were able to identify abnormal echocardiography images with an average score of 16 ± 3/20. An intense five-day echocardiography workshop significantly increased knowledge and skill in performing and interpreting basic pediatric echocardiograms for novice trainees and served as an excellent starting point for longitudinal future pediatric echocardiography training.