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

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.