A Badge-Sized Cognitive Aid and Pediatric Point-of-Care Ultrasound Integration in the Emergency Department

Abstract

Objectives: Point-of-care ultrasound (POCUS) is widely taught in pediatric emergency medicine, yet achieving confident, independent bedside scanning remains difficult for many trainees. To bridge this gap between knowledge and real-time performance, we evaluated a badge-sized, wearable cognitive aid designed to support learner confidence and POCUS use. Methods: We conducted a prospective educational intervention study in a tertiary pediatric emergency department between July 2024 and July 2025. Fellows and trainees received a badge-sized cognitive aid summarizing common pediatric POCUS applications. Self-reported confidence was measured at baseline and one month using 5-point Likert scales, with additional follow-up at 3 and 6 months for fellows. Changes were analyzed using Wilcoxon signed-rank tests with effect sizes calculated using Cohen’s d. Secondary outcomes included workflow integration and weekly POCUS use. Results: Forty-seven learners completed baseline surveys; 34 (72%) completed 1-month follow-up. Significant improvements were observed across all confidence domains at one month, including overall confidence (2.54 to 3.40, P <0.001; d=0.81), image acquisition (2.43 to 3.40, P <0.001; d=0.99), image interpretation (2.50 to 3.43, P <0.001; d=0.91), understanding of indications (3.33 to 3.80, P <0.001; d=0.49), and clinical integration (3.07 to 3.94, P <0.001; d=0.88). Improvements were sustained at 3 and 6 months. Self-reported weekly POCUS use increased over time. Conclusions: A badge-sized cognitive aid was associated with sustained improvements in learner confidence and increased POCUS use. Wearable cognitive supports may facilitate independent bedside POCUS integration during clinical training.

The authors' abstract, as published at the source. Pediatric Emergency Care, 2026 · DOI ↗