{ "abstract": "Bakcgroung: Training in pediatric and congenital echocardiography has progressed substantially over the past two decades, supported by structured recommendations in North America and Europe. However, while North American training pathways are generally more standardized and closely linked to accreditation and certification, European training remains heterogeneous. Differences in healthcare systems, regulatory frameworks, institutional organization, supervision, case exposure, and access to advanced imaging may result in unequal acquisition of competencies, with potential implications for patient care. The aim of this expert consensus document is to update European standards for training in pediatric and congenital echocardiography and to promote harmonization through a competency-based framework that complements, rather than replaces, national regulatory systems and existing certification pathways. Methods: Developed by the Imaging Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC), in collaboration with the Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI), the document defines three progressive levels of expertise: Basic, Advanced, and Specialized/Tertiary. Each level is characterized by specific competencies, indicative procedural experience, and expected professional responsibilities. Building on previous European recommendations and the recent joint statement addressing laboratory organization and service governance, this document focuses specifically on the educational pathway, progressive acquisition of clinical competencies, and assessment of individual practitioners. Results: The proposed framework emphasizes comprehensive training across the lifespan of congenital heart disease, including competencies bridging pediatric and adult cardiology. It incorporates contemporary imaging modalities, including three-dimensional echocardiography, myocardial deformation imaging, transesophageal and fetal echocardiography, and emerging blood speckle tracking and artificial intelligence applications. Minimum requirements for training centres, structured assessment, quality assurance, continuous professional development, research activity, and multidisciplinary collaboration are also addressed. Procedural volumes are proposed as indicative benchmarks to support training and assessment, not as stand-alone evidence of competence or universally mandatory thresholds. Conclusions: This consensus document provides a shared European reference framework designed to reduce unwarranted variability in training, facilitate professional mobility, promote competency-based progression, and ensure that pediatric and congenital echocardiography remain aligned with current clinical practice and technological innovation.", "abstract_shown": true, "affiliations": [ "Fondazione CNR-Regione Toscana G. Monasterio (FTGM), 54100 Massa, Italy", "Department of Pediatric Cardiology, Hospital Materno Infantil de Malaga, 29011 Málaga, Andalucia, Spain", "Department of Paediatric Cardiology, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands", "Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, 20097 Milan, Italy", "Department for Congenital Cardiology and Pediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany", "Division of Pediatric Cardiology, Spedali Riuniti, ASST Azienda Ospedaliera Papa Giovanni XXIII, 24127 Bergamo, Italy", "Paediatric Cardiology Department, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SW3 6NP, UK", "National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK", "The Heart Unit, Birmingham Children’s Hospital, Birmingham B4 6NL, UK", "Great Ormond Street Hospital for Children, London WC1N 3JH, UK", "Department of Pediatrics, Division of Pediatric Cardiology, Medical University Graz, 8036 Graz, Austria", "Department of Pediatric Cardiology, Evelina London Children’s Hospital, London SE1 7EH, UK", "Paediatric Cardiology and Congenital Heart Disease, Women and Children’s Health Department, University of Padua, Experimental Cardiology, Paediatric Research Institute, 35122 Padua, Italy", "Department of Paediatric Cardiology, Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland", "School of Medicine, University College of Dublin, D04 V1W8 Dublin, Ireland" ], "article_type": null, "arxiv": null, "author_total": 13, "authors": [ { "affs": [ 0 ], "name": "Massimiliano Cantinotti" }, { "affs": [ 1 ], "name": "Almudena Ortiz Garrido", "orcid": "0000-0003-0367-1339" }, { "affs": [ 2 ], "name": "Heynric B. Grotenhuis", "orcid": "0000-0002-9625-5969" }, { "affs": [ 3 ], "name": "Giulia Pasqualin", "orcid": "0000-0002-3362-4501" }, { "affs": [ 4 ], "name": "Inga Voges" }, { "affs": [ 5 ], "name": "Francesca Raimondi" }, { "affs": [ 6, 7 ], "name": "Sylvia Krupickova" }, { "affs": [ 8 ], "name": "Tristan Ramcharan", "orcid": "0000-0003-0197-0722" }, { "affs": [ 9 ], "name": "Beatrice Bonello" }, { "affs": [ 10 ], "name": "Martin Köstenberger", "orcid": "0000-0003-1766-7859" }, { "affs": [ 11 ], "name": "Owen Miller", "orcid": "0000-0003-1448-1012" }, { "affs": [ 12 ], "name": "Giovanni Di Salvo", "orcid": "0000-0002-0305-0113" }, { "affs": [ 13, 14 ], "name": "Colin J. McMahon", "orcid": "0000-0003-0337-9338" } ], "bibtex": "https://research.draconitic.com/paper/01c8xjz798dz2.bib", "cited_by": 0, "doi": "10.3390/jcm15228819", "fulltext_url": null, "id": "01c8xjz798dz2", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/22/8819", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [], "openalex": null, "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-11-11", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/01c8xjz798dz2.ris", "sources": [ { "first_seen": "2026-11-12T00:20:57Z", "native_id": "10.3390/jcm15228819", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/22/8819" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Basic and Advanced Training in Pediatric Cardiology and Congenital Heart Disease Echocardiography: An Expert Consensus Paper from the European Paediatric and Congenital Cardiology (AEPC) Imaging Working Group and Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI)", "title_text": "Basic and Advanced Training in Pediatric Cardiology and Congenital Heart Disease Echocardiography: An Expert Consensus Paper from the European Paediatric and Congenital Cardiology (AEPC) Imaging Working Group and Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI)", "type": "peer-reviewed", "updated_at": "2026-11-13T00:21:26Z", "url": "https://research.draconitic.com/paper/01c8xjz798dz2", "venue": "Journal of Clinical Medicine", "versions": [] }