255 - Improving Pediatric Resident Confidence And Competency Utilizing Critical Congenital Heart Disease Screening

Poster Number: 255
Publication Number: 255.330

Collin C. Kramer, UH Rainbow Babies & Children's Hospital, Cleveland Heights, OH, United States; Diana Drogalis-Kim, UH Rainbow Babies & Children's Hospital, Cleveland, OH, United States

Background: Critical congenital heart disease (CCHD) is defined as congenital heart disease requiring invasive intervention within the first year of life. Despite advances in obstetrics care and fetal cardiac imaging, CCHD occasionally goes undetected prenatally. If this occurs, infants can undergo rapid deterioration following hospital discharge. For this reason, undetected CCHD remains a significant source of infant morbidity and mortality in the US.

To address this issue, a standardized newborn CCHD screen (CCHDS) was implemented in the US over the past decade. Despite universal implementation in newborn nurseries, pediatric residents report poor confidence in interpreting CCHDS citing lack of formal training.

Objective: We set out to develop a brief teaching intervention with the goal of improving pediatric resident confidence and competence regarding the CCHDS. We emphasized the clinical indication for, interpretation of, and limitations of the CCHDS as key learning points.

Design/Methods: Pediatric residents in training at Rainbow Babies and Children’s Hospital were eligible to participate. The program includes 87 pediatric and 16 med-peds residents all of whom participate in newborn nursery and neonatal ICU rotations.

The educational intervention consisted of a slide presentation by the author (C.K.) and provided education a brief overview of CCHD, reasons for implementation of the screening, and how to perform/interpret the CCHDS as accepted by the Centers for Disease Control and Prevention (CDC). Anonymous pre-tests and post-tests evaluated pediatric residents’ ability and confidence interpreting the CCHDS.

Results: 17 pediatric residents across all training years participated in this single centered teaching intervention. Pre-intervention, 76% reported never receiving formal CCHDS training with average confidence level 4.2/10. Statistics were performed utilizing McNemar's test for formal multiple-choice questions and paired 2 sample t-test for confidence scale rating. Post-intervention, residents reported increased confidence levels (7.5/10) and statistically significant improvement in interpretation and understanding limitations of CCHDS (p < 0.05).Conclusion(s): There is a paucity of formal training for pediatric residents regarding CCHDS. A brief teaching module appears to significantly improve confidence and interpretation. This data suggest that residents may benefit from a formalized CCHDS education during training. Further multicenter studies are warranted to assess similar knowledge gaps in other training programs throughout the US.
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