Proposing Entrustable Professional Activities for Pediatric Critical Care Ultrasound: A Modified Delphi Consensus Approach

Abstract

Objective: Develop a consensus-based framework for point-of care ultrasound in pediatric critical care, or critical care ultrasound (CCUS) education using entrustable professional activities (EPAs).

Design: A modified Delphi method utilizing cycles of meetings and surveys for consensus-building.

Setting: The endeavor involved members of the Pediatric Research Collaborative on Critical Ultrasound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury And Sepsis Investigators.

Subjects: An expert panel consisting of 23 members representing 17 institutions, including diverse healthcare professionals involved in pediatric critical care ultrasound.

Interventions: Three iterative modified Delphi rounds were conducted to propose and refine critical care ultrasound EPAs.

Measurements and main results: The endeavor achieved a 74% response rate. Fourteen EPAs were formulated across five domains: Cardiac, Pulmonary, Abdomen, Procedures, and Vascular, along with two consensus opinions on educational content and methods. EPAs were evaluated using 5-point Likert items, requiring a median score of greater than or equal to 4.5 for progression.

Conclusions: This collaborative effort led to the establishment of fourteen EPAs for pediatric critical care ultrasound, offering a structured approach for education and competency assessment in pediatric critical care. This initiative lays the groundwork for evolving standards in pediatric critical care ultrasound education and practice.

Keywords: echocardiography; entrustable professional activities; medical education; point-of-care ultrasound; procedures.