Evaluation of a novel fetal echocardiography training programme in two tertiary care obstetric Centres

Abstract Objectives Improving and maintaining high detection rates for major congenital heart disease (CHD) is a priority for successful prenatal anatomy screening programmes. The primary objective of this study was to evaluate the utility of on‐site multidimensional targeted training in fetal cardiac screening. Methods A prospective study evaluating a targeted fetal echocardiography (FE) training programme in two obstetric tertiary care units was established. The programme was designed and approved by a dedicated fetal cardiology team. The one‐day intervention involved supervised hands‐on sonography and a prescribed educational programme for sonographers and doctors. The programme was completed by 23 trainees. Evaluation of the programme involved pre and post‐training questionnaires and retrospective evaluation of cardiac images from 10 randomly‐selected anatomy screening examinations performed by each trainee before and after training. Images were assessed for both technical quality and 6 priority elements of cardiac screening taught in the programme. The results were described with summary statistics and non‐parametric tests. Results 1850 fetal cardiac images obtained before and after training by 21/23 trainees were assessed. Significant improvement was seen in the priority cardiac views obtained, for example from 24%(5/21) to 86%(18/21) for bifurcating pulmonary artery ( P ‐value 0.001), from 33%(7/21) to 86%(17/21) for differential atrio‐ventricular valve insertion ( P ‐value 0.001), In addition, technical image quality improvements were observed following training as well as sonographer confidence. Conclusion A targeted FE training programme can improve understanding of the priority elements required to exclude major CHD in prenatal screening, improve image quality, and sonographer confidence in cardiac screening.