Integration of 3-dimensional Imaging into a Congenital Heart Disease Curriculum for the Cardiac Intensive Care Unit

Abstract

Objective: Successful management of congenital heart disease involves understanding complex 3-dimensional anatomy and physiology. Implementation of 3-dimensional imaging with medical education has shown to improve learner retention and selfefficacy. At our institution, care is provided by physicians with varied training backgrounds including Neonatology, Cardiology, Surgery, Pediatrics and Intensive Care. We evaluated the implementation of a surgical case-based curriculum incorporating 3D imaging across multiple platforms to our multidisciplinary providers over a six-month pilot study period. Methods: Surgical case-based lectures were developed utilizing 3D imaging derived from patient-specific radiologic studies and open source applications, incorporated with existing peer-reviewed curriculum. During the week of surgery, a thirty-minute didactic session reviewing pre-operative anatomy, physiology, surgical indications and options, and post-operative management was presented to the multidisciplinary team. Anonymous responses to “pre” and “post” surveys of knowledge, perceived care ability, session content and format, were compared utilizing ordinal logistic regression. The pilot study period lasted from July 2018 – January 2019. Results: 45 cardiac intensive care unit providers, mostly non-physicians [53%, (24/45)], with less than 2 years’ experience [48%, (22/45)] attended eight distinct case-based lectures throughout the study period. >80% of participants report strong agreement regarding effectiveness of the session format, including 3D imaging visualization. Our primary educational outcome measures included significant self-reported improvements in anatomic, physiologic, and surgical knowledge, and perceived care ability, independent of background and years’ experience. Conclusion: 3D imaging can be successfully integrated into clinical didactic curricula to refine knowledge and improve care ability for a broad range of congenital heart disease providers.