Diploma in Neonatal Cardiac POCUS

All candidates must meet the following prerequisites:

• • The program is offered in English only. Must have language proficiency in English.
  • The program is open to any neonatal care practitioner, who is currently actively practising in Neonatology/Pediatrics
  • The applicant must have access to an echo/ultrasound machine in their unit.

Once enrolled, you will be given access to our online educational portal to learn the basics of Cardiac POCUS and Hemodynamics.

The course modules are delivered online as structured teaching modules with interactive videos, slides, and quizzes. These modules will cover foundational knowledge and clinical applications in Neonatal cardiac POCUS.

Topics Covered:

1. Introduction to Point-of-Care Ultrasound (POCUS)
   • Principles of ultrasound physics and machine settings.
   • Neonatal-specific considerations.
2. Neonatal Cardiac Anatomy and Physiology
   • Normal neonatal cardiac anatomy.
   • Transitional circulation.
   • Hemodynamic changes in neonates.
3. Core Echocardiographic Views
   • Subcostal: 4-chamber, IVC.
   • Apical: 4-chamber, long axis.
   • Parasternal: Long axis, short axis.
   • Suprasternal: Aortic arch.
4. Assessment of Hemodynamics
   • Left ventricular output (LVO).
   • Right ventricular output (RVO).
   • Pulmonary artery pressure (PAP).
5. Evaluation of Neonatal Cardiac Function
   • Ejection fraction (EF)
   • Fractional shortening (FS).
6. Shunt Evaluation
   • Patent ductus arteriosus (PDA).
   • Atrial septal defect (ASD).
7. POCUS in Neonatal Emergencies
   • Hypotension and shock.
   • Persistent pulmonary hypertension of the newborn (PPHN).
   • Echocardiography-guided fluid and inotrope therapy.

Training with POCUSVISION Innovative Digital POCUS Simulator

• • All candidates will be given complimentary access for a week to our innovative ONLINE POCUS simulator, POCUSVISION®.
  • The online simulator is loaded with a variety of clinical cases in Cardiac POCUS.
  • The participants wished to get extended access to the online POCUS simulator by purchasing access through the POCUSVISION® portal. The training program does not cover the cost of this extended subscription.

Recommended for optimizing supervised hands-on training:

• • CNPOCUS conducts periodic in-person POCUS workshops in Canada and selected centres globally.
  • It is strongly recommended that the participant attend one of the workshops during their training period. (The registration cost for such workshops is pay-as-you-go and is not included in the training fee)
  • If participants, as an institution or as a private group, would like to organize a workshop in their local country/institution, CNPOCUS will arrange it. The local organizing team will bear the cost of such a private workshop. More information will be provided upon request.

Format: In-person, with expert faculty guidance.
Location: Designated centers supported by CNPOCUS and NeoPeds Academy.

Day 1: Basics of Neonatal Cardiac Ultrasound

• Machine setup, probe handling.
• Acquisition of core echocardiographic views
• Image optimization techniques.
• Scanning modes, basic measurements
• Image/clip archiving, interpretation and reporting skills

Day 2: Clinical Applications and Advanced Practice

• Functional echocardiography.
• Advanced Echocardiographic measurements
• Hemodynamic monitoring and interpretation.
• Shunt evaluation and PDA assessment.
• PPHN and shock evaluation and management

Logbook Maintenance and Review

Participants will maintain a logbook of all scans performed by them during the program, documenting:

• • Clinical indications.
  • The Echocardiographic views were acquired.
  • Key findings and their implications.

Faculty will review the logbook for:

• • Completeness.
  • Technical proficiency.
  • Progress over time.

Practice Steps:

• • The participant must start saving all echocardiograms performed by them in the NICU at their local computer system without patient identifiers.
  • The participant must submit the case history and echo clips relevant to the case to the CNPOCUS online case evaluation portal. The faculty mentor will provide feedback on technical acquisition, interpretation, and reporting skills and guidance to further improve their skills. A feedback document is provided through their registered email with a PDF attachment of all relevant details to be saved by the participant as a logbook. This is done through our sophisticated online portal governed by the CNPOCUS faculty team.
  • The participant and their local institution are responsible for de-identifying the patient information before saving it to their local system or uploading it to the CNPOCUS teaching portal for feedback and guidance. In this regard, the participant MUST adhere to their local institutional policies on patient privacy.
  • CNPOCUS will not be responsible legally for any breach of patient privacy for failure to protect by the participant

Remote Mentorship with Experienced Faculty

• • Participants will be paired with a faculty mentor for the duration of the program.
  • Regular monthly one-on-one sessions will focus on:
    • Monthly teaching topic for group learning and interactive discussions.
    • Addressing specific challenges noted in the scan acquisitions and their interpretation (anonymous feedback)
    • Case discussions, personalized guidance and feedback upon participant’s voluntary lead.

Format: Virtual live sessions led by expert faculty assigned to you. Focussing on:

• • Interpretation of complex cases.
  • Correlation of echocardiographic findings with clinical outcomes.
  • Updates in neonatal hemodynamics.
  • Troubleshooting common challenges in neonatal echocardiography.
  • Peer case presentations with faculty feedback.
  • Preparation for the exit exam.

Mentorship session curriculum:

Attendance/Offline Access to Mentorship sessions and recordings:

• • 80% of attendance is mandatory (The participant should not miss more than one mentorship session)
  • Each mentorship session is recorded online
  • The participant has access to all mentorship session recordings throughout the program

Access to Mock Exam:

Participants will have access to mock exams during the last 4 weeks of the program to get simulated practice for the final exam.

Final Exit Exam Eligibility

• • The participants must submit a minimum of 20 scans to their mentors and get score of minimum 4 out of 5 in atleast 15 case submissions.
  • Candidates who did not submit the required minimum cases will not be allowed sit in the final exam.
  • Candidates who were still not attaining the competency of 4/5 in technical and interpretive skills will be required to submit additional cases to demonstrate their competency attained
  • The CNPOCUS faculty mentor’s decision is final regarding the competency attained and eligibility to take the exit exam.
  • Appeal process for unsuccessful candidates: An appeal request can be submitted to the CNPOCUS educational committee if the candidate is in disagreement with the faculty mentor’s evaluation and final assessment
  • CNPOCUS Educational Steering Committee will evaluate case by case and issue their final decision by email to the candidate. This decision is final, and no further escalation is possible.

Final Exit Exam

• • The Final exit exam will be conducted online for those who are eligible (Please refer to the eligibility requirement given above).
  • The online assessment exam would include 20 – 45 multiple-choice questions, either single or multiple right-answer questions, with equal weightage for all questions.
  • Securing 75% is the cutoff for passing this final exit exam
  • Participants who pass the exam will receive the Diploma in Neonatal Cardiac POCUS from CNPOCUS .

Final Diploma Certificate:

• • Successful candidates will automatically receive their diploma certificate through their digital learning platform administered by CNPOCUS and Neopeds Academy.
  • All certificates will carry an embedded validation QR code, allowing online verification of the participant’s details and the authenticity of issuance.
  • Participants are requested to download and save it securely by themselves.
  • The issuance of the lost certificate could be requested by the candidate to the CNPOCUS team officially from their registered email ID. It will be sent out digitally within 1-2 weeks of a request by email.

Printed Diploma Certificate:

• • Candidates who wish to receive a printed diploma certificate (printed and embossed with CNPOCUS Emblem) could be prepared at their individual request and will be sent to their home address on record.
  • Printing, administrative and courier charges must be paid by the requesting candidate.

Transcript of the full training program:

• • The faculty could prepare a full training transcript, which will be provided to you by email free of cost.
  • Successful candidates must submit a request by email to support@cnpocus.org to receive their transcript document by email. If a printed transcript is required, the candidate must pay a fee similar to the printed diploma certificate request given above upon request by email.
  • Processing time: 2-3 weeks

Please note:

• • The Program Length is strictly 6 months.
  • The participant is not permitted to request any extension for any personal or institutional reasons.
  • CNPOCUS and Neopeds Academy are not responsible for candidates who are unable to achieve their competency within this stipulated training period.
  • If a Candidate cannot complete the set number of cases within the set program duration or does not achieve the competency set by CNPOCUS within the stipulated training period, will be labelled as unsuccessful and will be terminated at the program semester end date.
  • The candidate would then be required to re-enrol in the upcoming program by paying the registration fee again as a fresh applicant. Pending availability, a placement cannot be guaranteed.

Maintenance of Certification

• • Participants must keep practising POCUS at their institutions
  • CNPOCUS offers a Virtual Skills Maintenance Program through POCUSVISION® for a yearly subscription to get access to our Online POCUS simulator (NICU VISION) with challenging real-time cases provided to you every year.
  • Participants could participate in the Case Discussion Forum on the CNPOCUS website to exchange their experiences and insights on challenging cases they faced in their practice and seek guidance from faculty relevant to their cases.
  • Participants who excel in their maintenance of skills program will be eligible for consideration as future tutors for their local workshops as faculty members.