Educational needs, self-reported competency and curriculum priorities for point-of-care ultrasound among paediatric surgical providers across Africa: a multinational assessment

<title>Abstract</title> <p>Background Point-of-care ultrasound (POCUS) is increasingly recognised as a core clinical competency that can support timely diagnosis and procedural guidance across a wide range of paediatric surgical conditions. Despite growing international recommendations for competency-based POCUS education, little is known about current training opportunities, self-reported competency, and educational needs among paediatric surgical providers in Africa. This study aimed to evaluate access to ultrasound, POCUS utilisation, self-reported competency, and perceived educational needs to inform curriculum development and workforce capacity building. Methods We conducted a multinational cross-sectional online survey of paediatric surgical providers across Africa between March and October 2025 disseminated by the Pan-African Paediatric Surgical Association (PAPSA). The survey explored participant demographics, access to diagnostic imaging, previous POCUS training, POCUS utilisation, self-reported competency, and perceived clinical relevance of 22 diagnostic and five interventional POCUS applications. Descriptive statistics were used to summarise responses, and categorical variables were compared using Chi-squared or Fisher's exact tests. Results A total of 149 respondents from 29 African countries completed the survey. Departmental access to ultrasound was reported by 30.9% of participants, whereas 24.8% reported no access to ultrasound equipment. More than one-third (37.6%) did not use POCUS in routine clinical practice. Self-reported competency was limited, with 39.6% reporting no POCUS skills and only 7.4% considering themselves competent to teach others. Competency was positively associated with clinical experience and access to ultrasound equipment. Respondents identified acute abdominal pathology, neonatal imaging, trauma assessment, vascular access, and ultrasound-guided procedures as their highest educational priorities. All participants expressed interest in formal POCUS education, and 97.3% supported integration of competency-based POCUS training into paediatric surgical curricula. Conclusions This multinational needs assessment demonstrates substantial educational gaps in POCUS training among paediatric surgical providers across Africa despite strong perceived clinical relevance and universal demand for education. These findings support the development of competency-based curricula, faculty development initiatives, structured assessment frameworks, and sustainable governance strategies to strengthen the paediatric surgical workforce and improve equitable access to clinician-performed ultrasound across diverse healthcare settings.</p>