Assessment of Obstetrics and Gynecology Residents’ Knowledge of Basic Obstetric Sonography and Psychomotor Evaluation With Motion Analysis Using a Computer-Based Simulator (original) (raw)
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Obstetrics and Gynecology International
Objectives. To evaluate the competency of medical sonographer students who have completed training to estimate the gestational age (GA) and perform fetal biometric measurements compared to obstetricians. Methods. We conducted a cross-sectional observational study at the end of the medical sonographer students’ practice sessions. In total, 80 midtrimester (18–28 weeks) pregnant women were recruited, and an ultrasound was performed according to the International Society of Sonography in Obstetrics and Gynecology (ISUOG) guideline. Estimated GA calculated from fetal biometric measurements was compared between medical sonographer students and qualified obstetricians. Subsequently, images were randomly evaluated by maternal-fetal medicine specialists to assess the measurement performance. Results. There was no significant difference in the estimated GA between the medical sonographer students and obstetricians (mean difference, 0.01 ± 2.92 day, p = 0.89). However, there was a significan...
Journal of The American Board of Family Practice, 1994
Obstetric sonography is a valuable diagnostic procedure for famlly physicians who provide obstetrics; however, physicians tend to use technology that was effectively modeled during residency. The purpose of this study was to learn how many family medicine residency program directors had an interest in and a need for training in obstetric sonography, as well as whether they were wllling to commit faculty and finances for adding the technology to their programs. Methods: All program directors listed in the 1989 American Academy of Family Physicians (AAFP) Directory of Family Practke Residency Programs (n = 379) received a five-item questionnaire about obstetric services and use of sonograms in their programs and their desire for training in obstetric sonography. Results: More than 81 percent of respondents said their programs provided obstetrics. Sixty-eight percent of these respondents used sonograms, and 53 percent indicated a need for training in obstetric sonography. Forty-five percent of all respondents, regardless of whether their programs offered obstetrics, indicated a desire for training. Conclusions: The high level of interest in obstetric sonography can be explained, in part, by the 81 percent of respondents whose programs provided obstetrics. These figures suggest a need to establish a training curriculum in obstetric sonography for family medicine residency programs. Our training program, designed to reach faculty, residents, and practicing physicians, is described. (J Am Board Fam Pract 1994; 7:124-9.) Obstetric sonography is considered an important technological development in modern obstetric care.! The ability to see sonographically into the world of the unborn child has changed the fetus from an anxiously awaited stranger to a familiar person whose well-being can be assessed and whose interests can be safeguarded. Most of the major assessments and interventions of modern perinatal care have been made possible byobstetric sonography. In 1984 the National Institutes of Health Consensus Development Conference 2 established 28 specific indications for selective sonographic examinations during pregnancy. Since then, technological advances have improved resolution, the equip
Obstetrics and Gynecology Ultrasound Topics in Family Medicine Resident Training
Donald School Journal of Ultrasound in Obstetrics & Gynecology, 2014
Access to timely and appropriate prenatal and maternity care is widely known to be an important factor in improving birth outcomes. Family physicians make a significant contribution to the provision of prenatal care in the United States. The amount of exposure to maternity care and prenatal procedures in residency increase likelihood of incorporation of prenatal care in future practice. The use of prenatal ultrasounds has become standard in the management of pregnancy. Ultrasonography has wide application in obstetric care and is being used in screening and diagnosis during antenatal, intrapartum and postpartum periods. Family physicians that provide obstetric care should be trained to carry out basic obstetric ultrasound scans. In our paper, we have outlined an approach to the incorporation of ultrasound training into Family Medicine residency education. We have also explored the use of simulation as an adjunct to scanning live patients in a training curriculum. How to cite this ar...
American journal of obstetrics and gynecology, 2018
Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national and international guidelines for the performance of obstetric and gynecologic ultrasound examinations and thus are intended to represent the minimum requirement for such training. By expert consensus, the curriculum was developed for each year of training, criteria for each competency assessment image were generated, the pass score was established at, or close to, 75% for each, and obtaining a set of 5...
Australasian Journal of Ultrasound in Medicine, 2013
Introduction: The aim of this study is to provide a quantitative scoring system to assess sonographer performance by reviewing images from the fetal morphology examination. Methods: Ten ultrasound images from patients at 18-22 weeks gestation were assessed and scored for quality according to predefined criteria. One hundred normal cases were randomly selected and 10 images from each case were analysed by four experienced reviewers. The preliminary training incorporated the first 25 cases and involved a training period for reviewers; the remaining 75 cases were allocated to post training. The scores acquired by each reviewer were statistically analysed using Pearson's and intra-class correlations to determine the reproducibility of the results. Results: The preliminary training results were calculated separately and compared to the post training study. The preliminary intra-class correlation coefficient was 0.12. In the post training study the intraclass correlation coefficient was doubled at 0.24. The greatest correlation was observed between reviewers 1 and 4 with a coefficient of 0.71. Reviewers 3 and 4 demonstrated the lowest correlation coefficient of 0.30. Discussion: A significant increase in the intra-class correlation coefficient indicated that training reviewers achieves more reproducible results. Suggested improvements to the study include recording fetal position, maternal BMI and assessing individual reviewer variability. An instruction manual defining each criterion might also yield better results. Conclusion: The quantitative method used in this study assessed ultrasound images by placing a numerical value on image quality. Analysis of the preliminary training period demonstrates improved reproducibility of the results. Further investigation into the criteria is necessary to refine the quantitative method.
Clinical Simulation in Modern Teaching and Training of Sonography in Obstetrics and Gynecology
Donald School Journal of Ultrasound in Obstetrics and Gynecology, 2009
Advances in computer technology, hardware and software have made ultrasound a diagnostic imaging technique of choice in certain areas of medicine or specialties such as obstetrics and gynecology. In teaching and training of obs/gyne ultrasonography, medical educators can utilize different forms of clinical simulators: traditional standardized patients and standard ultrasound diagnostic equipment, computer-based simulators, ultrasound simulators or ultrasound simulators with manikins. The popularity of a simulator is determined not only by its features, ease of use and cost, but also by its available learning modules and applications. Technology in ultrasound and computers are rapidly advancing in enhancing the quality and miniaturizing ultrasound machines. Portable and handheld ultrasound equipments are quickly becoming indispensable diagnostic instruments in different health care settings especially the emergency rooms and physician offices. Concerns, however, remain related to the...
ACES: Accurate Cervical Evaluation With Sonography
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2015
Transvaginal sonographic cervical length screening is an important tool for the evaluation of preterm labor. However, a structured curriculum is lacking in obstetrics and gynecology residency programs. The Accurate Cervical Evaluation with Sonography (ACES) program was developed to address this deficiency and combines an online didactic course with a standardized performance assessment of live scans. We sought to evaluate the effectiveness of the ACES program to teach residents sonographic cervical length assessment. All obstetrics and gynecology residents at our institution were invited to participate from 2012 to 2013. The program consisted of an initial supervised transvaginal cervical evaluation, an online didactic course and written examination, and 5 subsequent supervised scans. The instructor performed an independent cervical length measurement at each encounter. The primary outcome was the difference in cervical length measurement between the resident and instructor. We hypo...
Donald School Journal of Ultrasound in Obstetrics and Gynecology, 2014
Objective The use of transabdominal and transvaginal ultrasound is the test of choice in many Obstetrics and Gynecology practices. The objective of our study is to demonstrate how simulated ultrasound teaching could improve residents’ knowledge between PGY1 and PGY2 years in the area of (1) the ability to perform an accurate transabdominal and transvaginal ultrasound in a sensitive manner, (2) to identify and describe normal and abnormal female pelvic sonographic findings for interpretation and (3) to demonstrate clinical sonographic correlation of the most common clinical presentations on pelvic ultrasound. Materials and methods A total of 24 residents participated in this course during their usual scheduled training period from July 2011 to July 2013. Twelve of the 24 residents had previously taken the course 1 year prior and were used to compare changes in their level of understanding of the subject matter. An introductory lecture with a precourse knowledge assessment was initial...
Effectiveness of a Labor Cervical Exam Model in Family Medicine and OB-GYN Residents
Family medicine, 2017
Labor cervical exam accuracy is an essential skill for family medicine and OB-GYN residents to master. To determine the effectiveness of simulation on labor cervical exam training, family medicine and OB-GYN residents were trained using a self-constructed PVC pipe-based cervical exam model during a short and intensive simulation workshop or "boot camp." A task trainer was constructed that allows for the blind examination of cervical dilation and effacement. This model was used in the training of first-year family medicine and OB-GYN residents during an 8 day simulation course. A longitudinal comparison of pre- and post-training accuracy was performed. Using a cohort design, the post-training accuracy of first-year family medicine and OB-GYN residents (interns) was also compared to second-fourth year OB-GYN residents. Use of the model by interns (n=25) resulted in significant improvements in the accuracy of their assessments of cervical dilation, but not effacement, and dec...
Usefulness of an Intrapartum Ultrasound Simulator (IUSim™) for Midwife Training: Results from an RCT
Fetal Diagnosis and Therapy, 2020
Introduction: We conducted a randomized study to determine whether a training session on a dedicated simulator (IUSim™) would facilitate the midwives in learning the technique of transperineal intrapartum ultrasound. Methods: Following a 30-min multimedia presentation including images and videos on how to obtain and measure the angle of progression (AoP) and the head-perineum distance (HPD), 6 midwives with no prior experience in intrapartum ultrasound were randomly split into 2 groups: 3 of them were assigned to the “training group” and 3 to the “control group.” The midwives belonging to the former group were taught to measure the 2 sonographic parameters during a 3-h practical session conducted on IUSim™ under the supervision of an expert obstetrician. In the following 3 months, all the 6 midwives were asked to independently perform transperineal ultrasound during their clinical practice and to measure on the acquired images either the AoP or the HPD. The sonographic images were e...