Evaluation of an Online Module for Fascia Iliaca Block Education for Pediatric Femur Fractures in the Pediatric Emergency Department

PURPOSE: Point-of-care ultrasound-guided fascia iliaca nerve block (POCUS-FINB) is an effective method for pain control in children with femur fractures. Many pediatric emergency medicine (PEM) providers have not been trained in this technique, and there is no standard curriculum. While other studies have evaluated in-person POCUS-FINB didactics, assessment of online educational interventions is lacking. We created and implemented a novel online POCUS-FINB module and evaluated its efficacy in knowledge, confidence, and technical skill acquisition among PEM physicians. METHODS: This was a prospective presurvey and postsurvey study of PEM attendings and fellows. The curriculum was developed using the Kern 6-step framework and included an online module and a brief hands-on session. Confidence, knowledge, and technical skills were assessed using a Likert scale, multiple-choice tests, and an observation checklist, respectively. In addition, we reviewed the proportion of eligible patients who received POCUS-FINB at our institution precurriculum and postcurriculum implementation. RESULTS: Twenty-seven PEM physicians in 2 pediatric emergency departments participated in the study. Twenty-two completed all assessments from January 2022 to July 2023. Physicians demonstrated improved confidence with POCUS-FINB methods after completion of the online curriculum, with 4% reporting being confident or very confident before and 71% after the module (P<0.001). On the knowledge test, there was a statistically significant improvement, with mean scores from 77% premodule to 95% postmodule (P<0.001). Immediately after the module, participants scored well in technical skills with a mean score of 92%. There was a significant increase in the proportion of eligible patients with femur fractures who received blocks over the study period, 19% during the premodule period and 38% during the postmodule period (P=0.046). CONCLUSION: After completing a web-based curriculum for POCUS-FINB, PEM physicians showed improvement in confidence and knowledge and performed well in their technical skills.