A Structured Approach to Teaching Volumetric Fetal Echocardiography Using Fetal Intelligent Navigation Echocardiography (FINE)

Fetal volumetric echocardiography using Fetal Intelligent Navigation Echocardiography (FINE) enables automated reconstruction of standardized echocardiographic views from a cardiac volume dataset. However, automation of navigation does not eliminate dependence on technically adequate acquisition or the need for operator quality control. We describe the PROBE Educational Workflow, a structured educational approach comprising five sequential steps-Position, Refine, Obtain, Build and Evaluate-designed to organize the teaching of the process from preparation of the two-dimensional image and acquisition of the Spatio-Temporal Image Correlation (STIC) volume to construction of the navigation and systematic assessment of the reconstructed views. PROBE was conceived as an iterative workflow: when the quality of a step is considered insufficient, the operator should identify the probable origin of the problem and return to the corresponding step before proceeding. The workflow does not modify the FINE algorithm and does not constitute a diagnostic protocol; its purpose is to provide a simple and reproducible cognitive framework for technical training in volumetric fetal echocardiography. Future studies should assess its impact on competency acquisition, volume quality, reproducibility and training efficiency.