SHM Converge Scientific Abstract ePoster Gallery-Training Pediatric Residents in Ultrasound-Assisted Lumbar Punctures

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This mixed-methods, IRB-exempt study evaluated whether training pediatric residents to perform ultrasound-assisted lumbar punctures (UALPs) would improve their skills, confidence, and willingness to use point-of-care ultrasound (POCUS). The authors note that lumbar puncture success rates among graduating pediatric residents are only about 54%, and many residents feel uncomfortable performing the procedure. While UALPs have been shown to improve success rates and provider confidence in other settings, most pediatric residents have limited formal ultrasound training.<br /><br />The intervention included three phases: online modules, didactic teaching, and an in-person hands-on workshop with simulation. Of 24 participating residents, 10 completed all optional follow-up measures, allowing paired analysis.<br /><br />Results showed that residents’ ability to identify and label ultrasound landmarks improved from 34% at the time of training to 72% three months later. Their estimated LP success rate also rose from 37% to 45%. Immediately after training, residents reported higher self-efficacy and stronger acceptance of POCUS, but both declined significantly by three months. Ratings of the quality of education in traditional LPs improved, while ratings specific to UALPs dropped over time. Residents’ intention to use POCUS and perceived usefulness were also significantly lower at follow-up. Despite poor real-world use of UALPs, residents’ self-efficacy for performing traditional LPs increased over time.<br /><br />Qualitative feedback suggested several barriers to implementation, including difficulty acquiring ultrasound images, extra time required, limited perceived added value, lack of ongoing supervision, and limited access to ultrasound machines. The authors conclude that UALP training improved residents’ picture recognition and confidence, but without continued clinical reinforcement, POCUS skills and acceptance faded. They suggest that UALP may serve more as a learning scaffold for traditional LPs than as a routine clinical tool, and call for further research on its role and on better tools to measure POCUS competency.

Asset Subtitle

Ngozi Eboh

Meta Tag

Author List Amber Wright, Ngozi Eboh, Steven Crooks

Category Research

Concept Ultrasound-assisted paramedian lumbar puncture

Concept Landmark Identification

Concept Resident Training Intervention

Concept Procedural Self-Efficacy

Concept Pediatric Patient

Distinguished Non-Finalist

Presenter Organization Texas Tech University Health Sciences Center

Presenting Author Ngozi Eboh

Track Technology in Hospital Medicine

Keywords

pediatric residents

ultrasound-assisted lumbar puncture

point-of-care ultrasound

POCUS training

mixed-methods study

self-efficacy

lumbar puncture success

simulation workshop

ultrasound landmarks

clinical reinforcement

Ultrasound-assisted paramedian lumbar puncture

Landmark Identification

Resident Training Intervention

Procedural Self-Efficacy

Pediatric Patient