P114: Critical objectives for a pediatric emergency medicine fellowship point of care ultrasound curriculum

Introduction: Emergency Medicine Physicians have been incorporating Point-of-Care Ultrasound (POCUS) into their practice for over twenty years. Only recently has its use become more widespread in the practice of Pediatric Emergency Medicine (PEM). Recent guidelines have described the scope of applications for PEM physicians. However, no consensus exists as to which applications should be prioritized and routinely taught to PEM fellowship trainees and therefore expected of PEM graduates as they enter practice. The PEM POCUS Network, a multinational group of Physicians with POCUS expertise formed in 2014, set out to reach expert consensus as to which applications should be incorporated into PEM fellowship training curricula. Methods: A multinational group of PEM POCUS experts was recruited from the PEM POCUS Network via a screening process that identified PEM physicians who have performed over 1000 pediatric POCUS scans and met any of one of the following criteria: having 3 years or more experience teaching POCUS to PEM fellows, being local academic POCUS leaders or had completed a dedicated PEM POCUS fellowship. These experts rated each of the 60 possible PEM POCUS applications using a modified Delphi consensus building technique for their importance in inclusion into a PEM Fellowship curriculum. Consensus was reached when >80% of respondents agreed to include or exclude each item. Results: In the first round, 66 out of 92 (72%) PEM POCUS Network members responded to the survey email, of whom 45 met expert criteria and completed the first round. During round 1, consensus was reached to include 18 of the 60 applications in a PEM fellowship curriculum and to exclude 2 applications from a PEM fellowship curriculum. Eighty-two percent (37 /45) of the experts completed Round 2 where 40 items were rated; consensus was reached to include 3 additional applications and exclude 5 applications. The decision was made not to carry on with future rounds after this stage, since no significant changes were observed between the two rounds, with regard to items that had not reached consensus. Conclusion: This project of the PEM POCUS Network reached consensus on 21 applications that should be included in a PEM Fellowship curriculum. This project will have significant impact on how PEM fellowships teach POCUS to their trainees.