Development and implementation of a comprehensive postgraduate ultrasound curriculum for residents in obstetrics and gynecology: a feasibility study

Innovations in ultrasound training in obstetrics

INTRODUCTION

Ultrasound technology is critical in obstetrics, enabling detailed examination of the fetus and maternal anatomy. However, increasing complexity demands specialised training to maximise its potential. This study explores innovative approaches to ultrasound training in obstetrics, focussing on enhancing diagnostic skills and patient safety.

METHODS

This review examines recent innovations in ultrasound training, including competency-based medical education (CBME), simulation technologies, technology-based resources, artificial intelligence (AI), and online-learning platforms. Traditional training methods such as theoretical learning, practical experience, and peer learning are also discussed to provide a comprehensive view of current practises.

RESULTS

Innovations in ultrasound training include the use of high-fidelity simulators, virtual reality (VR), augmented reality (AR), and hybrid-learning platforms. Simulation technologies offer reproducibility, risk-free learning, diverse scenarios, and immediate feedback. AI and machine learning facilitate personalised-learning paths, real-time feedback, and automated-image analysis. Online-learning platforms and e-learning methods provide flexible, accessible, and cost-effective education. Gamification enhances learning motivation and engagement through educational games and virtual competitions.

DISCUSSION

The integration of innovative technologies in ultrasound training significantly improves diagnostic skills, learner confidence, and patient safety. However, challenges such as high costs, the need for comprehensive instructor training, and integration into existing programs must be addressed. Standardisation and certification ensure high-quality and consistent training. Future developments in AI, VR, and 3D printing promise further advancements in ultrasound education.

CONCLUSION

Innovations in ultrasound training in obstetrics offer significant improvements in medical education and patient care. The successful implementation and continuous development of these technologies are crucial to meet the growing demands of modern obstetrics.

Medical student training with next-generation handheld ultrasound devices - hands on examination of fetal biometry in obstetrics

INTRODUCTION

The technical development of ultrasound devices based on silicon chips has revolutionized ultrasound examinations, leading to the implementation of these portable handheld devices (PUD) in different medical fields. However, training on these devices is necessary to assure appropriate use and ensure valid results. While training programs for the use of conventional standard ultrasound devices (SUD) have been described, no training program for these handheld devices has been developed thus far.

METHODS

A training program for obstetric ultrasound examination was modified through the addition of an extra module focusing on the use of these PUDs. After the module the students had to attend an OSCE in which their skills of using the PUD and the SUD were tested and analyzed by applying the agreement rate, the intraclass correlation coefficient (ICC) and Bland-Altman plots. Furthermore, the students' ultrasound results were compared with those of trained physicians by employing the one-sample Student's t-test. After the OSCE, the students answered a survey regarding their experience and their expected use of these devices.

RESULT

An agreement of one hundred percent was reached for basic parameters such as fetal position, placental position, fetal heartbeat and for the classification of the amniotic fluid. The ICC showed a good to moderate agreement between the results of fetal biometry achieved by SUD and PUD. The T-test results confirmed a high reliability between the physicians' results and the students' results, independent of the used device. The students remarked a good handling of the ultrasound devices and supported the use in their future specialties.

DISCUSSION

The reliability between the examinations using the SUD and PUD were high but lower than the results observed for trained physicians. Therefore, the implementation of an additional module for portable ultrasound teaches the students to reliably examine basic obstetric parameters and provides a solid basis for further training and improvement of ultrasound skills in use of PUD.

Current status of ultrasound training in obstetrics and gynecology: a scoping literature review

Introduction

As a widely accessible, cost-effective, and safe imaging tool, obstetric and gynecologic (OB/GYN) ultrasound (ULS) plays a vital role in diagnostics and patient care. With its growing relevance, the demand for comprehensive education in this field increases. The objective of this work was to outline the current state of OB/GYN ULS education.

Methods

A scoping literature search was performed until May 2023 using the medical database PubMed according to PRISMA guidelines. Using specific keywords, relevant publications were filtered. Subsequently, abstracts were independently reviewed by two authors and the inclusion of each publication was assessed against pre-defined key search terms. Full-text versions of the included publications were scrutinized and pertinent information was extracted.

Results

In this review, 126 articles from the literature search matched the inclusion criteria and were investigated. Our findings revealed a diverse range of course concepts and programs, a lot of them not meeting the expectations of trainees and international guidelines. OB/GYN ULS training primarily targets residents, yet opportunities for early exposure and continuing education are underexplored. International organizations, such as the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and the German Society for Ultrasound in Medicine (DEGUM) have proposed guidelines and curricula for standardized training. However, adoption remains varied. There is an emergent need to innovate teaching methods.

Conclusion

There is consensus that standardizing OB/GYN ULS curricula could enhance training quality and streamline the creation of new programs, ultimately improving patient care. Further research is needed to define the most effective strategies for curriculum development and implementation.

Enhancing ultrasound education in obstetrics and gynecology in Germany: insights and innovations from postgraduate training

BACKGROUND

Ultrasound (US) has become integral to obstetrics and gynecology (Ob/Gyn), necessitating proficient training during residency. Despite its clinical importance, there is a perceived gap in the quality and structure of postgraduate ultrasound education in Germany.

METHODS

A cross-sectional survey was conducted among Ob/Gyn residents in Germany from October 2023 to March 2024, using the LimeSurvey platform. The survey, distributed via email, social media, and physical flyers, garnered 211 participants, with 115 completing all sections. The questionnaire covered demographic details, US training experiences, and the perceived importance of US in clinical practice.

RESULTS

Although US was highly valued by respondents, with an average of 26.1% of their clinical activity devoted to it, there was significant dissatisfaction with the training quality. Key issues included inadequate supervision, the necessity of self-training, and low participation in certification courses. Despite 93.0% awareness of professional US organizations like the German Society for Ultrasound in Medicine (DEGUM), engagement with structured training programs was minimal.

DISCUSSION

The study highlights a critical need for standardized US training protocols and curricular reform in Ob/Gyn residencies in Germany. The discrepancy between the recognized importance of US and the quality of training indicates a pressing need for improvements. Addressing these gaps through comprehensive, structured educational reforms could significantly enhance the proficiency and confidence of future Ob/Gyn specialists, ultimately improving patient care.

Controlled prospective study on ultrasound simulation training in fetal echocardiography: FESIM II

PURPOSE

To analyze the learning curves of ultrasound novices in fetal echocardiography during structured simulation-based ultrasound training (SIM-UT) including a virtual, randomly moving fetus.

METHODS

11 medical students with minimal (< 10 h) prior obstetric ultrasound experience underwent 12 h of structured fetal echocardiography SIM-UT in individual hands-on sessions during a 6-week training program. Their learning progress was assessed with standardized tests after 2, 4, and 6 weeks of SIM-UT. Participants were asked to obtain 11 fetal echocardiography standard planes (in accordance with ISUOG and AHA guidelines) as quickly as possible. All tests were carried out under real life, examination-like conditions on a healthy, randomly moving fetus. Subsequently, we analyzed the rate of correctly obtained images and the total time to completion (TTC). As reference groups, 10 Ob/Gyn physicians (median of 750 previously performed Ob/Gyn scans) and 10 fetal echocardiography experts (median of 15,000 previously performed Ob/Gyn scans) were examined with the same standardized tests.

RESULTS

The students showed a consistent and steady improvement of their ultrasound performance during the training program. After 2 weeks, they were able to obtain > 95% of the standard planes correctly. After 6 weeks, they were significantly faster than the physician group (p < 0.001) and no longer significantly slower than the expert group (p = 0.944).

CONCLUSION

SIM-UT is highly effective to learn fetal echocardiography. Regarding the acquisition of the AHA/ISUOG fetal echocardiography standard planes, the students were able to reach the same skill level as the expert group within 6 weeks.