Abstract
Background
Ultrasound has emerged as an important diagnostic tool in the management of multiple obstetric pathologies. However, the poor skills of trainee doctors in the application of ultrasound can significantly impact clinical outcomes. To overcome these challenges, simulation-based training can bridge the gap in skills and enhance the quality of patient care.
Materials and methods
The ultrasound simulation training curriculum involved virtual-reality simulator training to assist residents in acquiring competencies for accurate and holistic care of pregnant patients and complicated pregnancies. After hands-on training on the simulator, evaluation was done using pre- and post-tests based on the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale and image-based questionnaire. Quantitative data was compared using paired t-tests.
Result
A total 28 resident doctors completed the study. Participants reported an increase in mean response score to the image-based questionnaire following the training, with a mean pre-score of 9.86/15 and mean post-score of 11.43/15 with a mean improvement score 1.57 points (95%CI 1.64–1.5, p < 0.05). Objective assessments improved significantly across OSAUS scores following training, with 14.79/25 (SD 2.79) Pre-training and 19.36 (SD 3.03) post-training mean improvement score 4.57 points (95% CI 3.91–5.23, p < 0.05). It was noted that scores for systematic approach and documentation were most improved.
Conclusion
This study highlights the effectiveness of a simulation-based training curriculum in improving the ability of residents in scanning, especially with regard to a systematic approach and documentation of ultrasound scans. The use of virtual reality ultrasound simulator training can be an effective way to bridge the learning gap in ultrasound scanning.
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References
Lewis J, Rosen C, Grossestreuer A, et al. Diagnostic error, quality assurance, and medical malpractice/risk management education in emergency medicine residency training programs. Diagnosis. 2019;6(2):173–8. https://doi.org/10.1515/dx-2018-0079.
Windrim C, Higgins MF. Trans-vaginal ultrasound simulation: An exploratory qualitative research study focused on the end-users perception of learning [Internet]. Euro J Obstet Gynecol Reproduct Biol. 2022; 270:201–5. https://doi.org/10.1016/j.ejogrb.2022.01.015
Williams CJ, Edie JC, Mulloy B et al. Transvaginal ultrasound simulation and its effect on trainee confidence levels: a replacement for initial clinical training? [Internet]. Ultrasound. 2013; 21:50–6. https://doi.org/10.1177/1742271X13481215
Arya S, Dwivedi A, Mulla ZD, et al. Effectiveness of ultrasound simulation in obstetrics and gynecology education: a state-of-the-art review. Donald School J Ultrasound Obstet Gynecol. 2017;11(2):115–25.
Madsen ME, Konge L, Nørgaard LN, et al. Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination [Internet]. Ultrasound Obstet Gynecol. 2014; 44:693–9. https://doi.org/10.1002/uog.13400
Etienne M, Gabay L, Levaillant JM, et al. Benefits of using a simulator in the initial training for transvaginal ultrasound examination in gynecologic emergency unit [Internet]. J Gynecol Obstet Human Reprod. 2020; 50:101938. https://doi.org/10.1016/j.jogoh.2020.101938
Pearson J, Greminger A, Onello E, et al. Teaching the evaluation of female pelvic pain: a hands-on simulation to reinforce exam skills and introduce transvaginal ultrasound [Internet]. MedEdPORTAL. Association of American Medical Colleges; 2021. https://doi.org/10.15766/mep_2374-8265.11080
Al-Memar M, Saso S, Bobdiwala S, et al. Validation of a virtual reality simulator for the use of transvaginal ultrasonography in gynaecology and early pregnancy [Internet]. Austr J Ultrasound Med. 2017; 20:97–105. https://doi.org/10.1002/ajum.12052
Gibbs V. The role of ultrasound simulators in education: an investigation into sonography student experiences and clinical mentor perceptions [Internet]. Ultrasound. 2015; 23:204–11. https://doi.org/10.1177/1742271X15604665
Dromey BP, Peebles DM, Stoyanov DV. A systematic review and meta-analysis of the use of high-fidelity simulation in obstetric ultrasound [Internet]. Simulat Healthcare J Soc Simulat Healthcare. 2020; 16:52–9. https://doi.org/10.1097/SIH.0000000000000485
Nwanodi O. Simulation in general obstetrics and gynecology [Internet]. J Womens Health Issues Care. 2017; 06. https://doi.org/10.4172/2325-9795.1000261
Tolsgaard MG, Ringsted C, Rosthøj S, et al. the effects of simulation-based transvaginal ultrasound training on quality and efficiency of care [Internet]. Ann Surg. 2017; 265:630–7. https://doi.org/10.1097/SLA.0000000000001656
Ahmad R, Alhashmi G, Ajlan A, et al. Impact of high-fidelity transvaginal ultrasound simulation for radiology on residents’ performance and satisfaction [Internet]. Acad Radiol. 2015; 22:234–9. https://doi.org/10.1016/j.acra.2014.09.006
Tolsgaard MG, Todsen T, Sorensen JL, et al. International multispecialty consensus on how to evaluate ultrasound competence: a delphi consensus survey [Internet]. PLoS ONE. Public Library of Science (PLoS) 2013; 8:e57687. https://doi.org/10.1371/journal.pone.0057687
Bhoopatkar H, Wearn A, Vnuk A. Medical students’ experience of performing female pelvic examinations: Opportunities and barriers [Internet]. Aust N Z J Obstet Gynaecol. 2017; 57:514–9. https://doi.org/10.1111/ajo.12634
Chao C, Chalouhi GE, Bouhanna P, et al. Randomized clinical trial of virtual reality simulation training for transvaginal gynecologic ultrasound skills [Internet]. J Ultrasound Med. 2015; 34:1663–7. https://doi.org/10.7863/ultra.15.14.09063
Andreasen LA, Tabor A, Nørgaard LN, et al. Multicenter randomized trial exploring effects of simulation-based ultrasound training on obstetricians’ diagnostic accuracy: value for experienced operators [Internet]. Ultrasound Obstet Gynecol. 2020; 55:523–9. https://doi.org/10.1002/uog.20362
Byford S, Janssens S, Cook R. Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars [Internet]. Adv Simulat. 2021; 6. https://doi.org/10.1186/s41077-020-00152-y
Tolsgaard MG, Ringsted C, Dreisler E, et al. Sustained effect of simulation-based ultrasound training on clinical performance: a randomized trial [Internet]. Ultrasound Obstet Gynecol. 2015;46:312–8. https://doi.org/10.1002/uog.14780
Roussin C, Sawyer T, Weinstock P. Assessing competency using simulation: the SimZones approach. BMJ Simul Technol Enhanc Learn. 2020;6(5):262–7. https://doi.org/10.1136/bmjstel-2019-000480 (Published 2020 Sep 3)
Tolsgaard MG, Ringsted C, Dreisler E, et al. Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology [Internet]. Ultrasound Obstet Gynecol. 2014;43:437–43. https://doi.org/10.1002/uog.13198
Acknowledgements
I would like to thank all my professor, guides, head of the department, and Dean sir, for giving their valuable guidance during my research. I would also like to thank my friends and family for their constant encouragement and support during the research period.
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Pradyumna Powalkar is a M.B.B.S. Intern, Dr. Neelima Shah is a Associate Professor, Dr. Pradip Patil is a Professor, Dr. Sanket Patil is a Centre Head, Dr. Rakeshkumar Sharma is a Dean, Professor, Dr. Vaidehi Jethwa is a Resident Doctor, Neha Sancheti is a M.B.B.S. Student.
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Powalkar, P., Shah, N., Patil, P. et al. Role of Ultrasound Simulator in Training of Resident Doctors to Diagnose Obstetrics Pathologies. J Obstet Gynecol India (2024). https://doi.org/10.1007/s13224-023-01921-1
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DOI: https://doi.org/10.1007/s13224-023-01921-1