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Current State of Fetal Heart Disease Counseling and Training: Room for Improvement?

Endorsed by the Fetal Heart Society

  • Original Article
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Abstract

We sought to describe the fellowship experiences and current practice habits of pediatric cardiologists who counsel patients with fetal heart disease (FHD) and to identify fellowship experiences related to FHD counseling perceived as valuable by respondents as well as opportunities for improvement. A cross-sectional survey of attending pediatric cardiologists who care for patients with FHD was performed. The respondents’ demographics, fellowship experiences related to FHD counseling, reflections on fellowship training, and current practice habits were collected. The Fetal Heart Society endorsed this survey. There were 164 survey responses. 56% of respondents did not have 4th-year subspecialty training in fetal cardiology. Observing and performing FHD counseling were the most commonly used methods of training, with the highest perceived effectiveness. The number of counseling sessions observed and performed correlated moderately with confidence in FHD counseling skills at fellowship graduation. Extracardiac pathology and neurodevelopment were the least frequently addressed topics in fellowship training and in current practice. Fewer than 50% of respondents received formal education and feedback in counseling techniques during fellowship training. A significant proportion of practicing pediatric cardiologists provide FHD counseling with only standard categorical training. This highlights the potential importance of expanding FHD counseling education into categorical fellowship curricula. We suggest increasing opportunities for fellows to perform FHD counseling and receive feedback as this is a valued and beneficial experience during training. A formalized curriculum including extracardiac pathology and neurodevelopment and the use of evidence-based workshops in counseling techniques may address identified gaps in fellowship education.

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Abbreviations

FHD:

Fetal heart disease

VSD:

Ventricular septal defect

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Funding

Funding for Redcap database supported by the division of Pediatric Cardiology, Department of Pediatrics, Mount Sinai Kravis Children’s Hospital.

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Author notes

  1. Jenna A. Keelan

    Present address: Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, Mount Sinai Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jenna A. Keelan, Kenan W. D. Stern & Miwa K. Geiger

  2. Division of Pediatric Cardiology, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA

    Anita J. Moon Grady

  3. Division of Cardiology, Department of Pediatrics, Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, WA, USA

    Bhawna Arya

  4. Division of Pediatric Cardiology, Children’s National Hospital, George Washington University School of Medicine, Washington, DC, USA

    Mary T. Donofrio

  5. Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    David N. Schidlow

  6. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    David N. Schidlow

  7. Department of Pediatrics, Division of Pediatric Cardiology, Stanford University School of Medicine, Stanford, CA, USA

    Theresa A. Tacy

Authors
  1. Jenna A. Keelan
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  2. Anita J. Moon Grady
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  3. Bhawna Arya
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  4. Mary T. Donofrio
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  6. Theresa A. Tacy
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  7. Kenan W. D. Stern
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  8. Miwa K. Geiger
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Contributions

Drs JAK and MKG conceptualized and designed the study, designed the data collection instrument, collected data, carried out the analysis, drafted the initial manuscript, and reviewed and revised the manuscript. Dr KWDS reviewed and revised the data collection instrument and reviewed and revised the manuscript. Drs AJMG, BA, MTD, DNS, and TAT critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jenna A. Keelan.

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The authors have no conflict of interest relevant to this article to disclose.

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Keelan, J.A., Moon Grady, A.J., Arya, B. et al. Current State of Fetal Heart Disease Counseling and Training: Room for Improvement?. Pediatr Cardiol 43, 1548–1558 (2022). https://doi.org/10.1007/s00246-022-02882-4

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  • DOI: https://doi.org/10.1007/s00246-022-02882-4

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