380 - Evaluation of an Online Module for Fascia Iliaca Block Education for Pediatric Femur Fractures in the Pediatric Emergency Department
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 380 Publication Number: 380.405
Mukuka Kangwa, UCSF Benioff Children's Hospital Oakland, Burlingame, CA, United States; Ashkon Shaahinfar, UCSF Departments of Emergency Medicine and Pediatrics, Oakland, CA, United States; Newton Addo, University of California, San Francisco, San Francisco, CA, United States; Margaret Lin-Martore, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States
Pediatric Emergency Medicine Fellow UCSF Benioff Children's Hospital Oakland Burlingame, California, United States
Background: Point-of-care ultrasound guided fascia iliaca nerve block (POCUS-FINB) is an effective method for pain control for children with femur fractures, but 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 are lacking. Objective: We aimed to create and implement a novel online POCUS-FINB module and evaluate its efficacy in knowledge, confidence, and technical skill acquisition among PEM physicians. Design/Methods: We performed a prospective pre/post survey studyfor PEM attendings and fellows undertaking a POCUS-FINB curriculum. The curriculum was developed using Kern’s framework with a pediatric anesthesiologist and POCUS experts and included an interactive online module and brief hands-on practice. Comfort was assessed using a self-report survey (Likert scale). Knowledge was assessed with a multiple-choice test. Technical skill was determined by a direct observation checklist.We also reviewed the number of POCUS-FINB performed in the pediatric emergency setting at our institution per year pre- and post- curriculum implementation. Results: A total of 27 eligible PEM physicians at two institutions participated in the study. 22 completed all assessments (18 attendings, 4 fellows; 81% completion) from Jan 2022-present (rolling enrollment). Physicians demonstrated improved confidence in their knowledge with POCUS- FINB methods after completion of the online curriculum, with 4% reporting confident or very confident prior to the course and 71% after the course (p < 0.001). On the knowledge test, there was statistically significant improvement with mean scores of 76.7% pre-module to 94.6% post-module (p < 0.001). Immediately after the module, participants scored well in technical skills with a mean score of 21.6/23.5 (92%). For the three years prior to the curriculum an average of 4.7 POCUS-FINB were performed in total per year compared with 10 in the year after the intervention.
Conclusion(s): After completing a web-based curriculum for POCUS-FINB, PEM physicians showed improvement in confidence and knowledge, and performed well in technical skill in POCUS-FINB.
