Efficacy of a Flipped Classroom, Simulation-Based, Ultrasound Curriculum for Pediatric Residents

We sought to evaluate the efficacy of a novel, flipped classroom, simulation-based, longitudinal curriculum for pediatric residents, in improving POCUS knowledge, and image acquisition skills.

We conducted a prospective single-center observational study of 39 PGY1 pediatric residents . The course consisted of 3 sessions from September 2024 to June of 2025: (1) soft tissue and E-FAST didactic/cases, (2) respiratory distress and shock didactic/cases, and (3) hands-on live scanning in an urban emergency department. Prior to sessions 1 and 2, the residents were asked to complete 6 web-based POCUS courses. Residents had to attend all 3 sessions to be included, leaving 19 for final analysis. Our primary outcomes were written test performance to assess POCUS knowledge and lung objective structured clinical examination (OSCE) to assess image acquisition and interpretation. Secondary analysis focused on survey responses for comfort with POCUS applications and effectiveness of the course. Paired t tests and Wilcoxon Signed Rank Test were used for PreCourse to PostCourse comparison.

Participants (n=19) demonstrated significant improvement on the written test with a pretest score of 48% (44-52%) and posttest score of 63% (57-69%). (p<0.001). Participants showed significant improvement in content area subscores of soft tissue, E-FAST, and shock. Participants had significant improvement in the lung OSCE exam with a PreCourse score of 39% (29-49%) and PostCourse score of 88% (83-93%). ( p<0.001). Participants had significant improvement in self-reported comfort with performing POCUS exams (95CI: 1.5 to 2.5 categorical improvement, p < 0.001).

A flipped classroom, simulation-based, longitudinal POCUS curriculum was effective in improving participants' fund of knowledge, image acquisition, interpretation, and integration into clinical decision making, while also improving comfort with different POCUS applications.