Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

Advances in Simulation - Tập 6 - Trang 1-7 - 2021
Sally Byford1, Sarah Janssens2, Rachel Cook1
1Mater Health, Mater Hospital, Brisbane, Australia
2Mater Education, Mater Hospital, Brisbane, Australia

Tóm tắt

Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.

Tài liệu tham khảo

Bradley E, Hamilton-Fairley D. Managing miscarriage in early pregnancy assessment units. Hosp Med (London, England : 1998). 1998;59(6):451. Haider Z, Condous G, Khalid, et al. Impact of the availability of sonography in the acute gynecology unit. Ultrasound Obstet Gynecol. 2006;28(2):207–13. https://doi.org/10.1002/uog.2801. Ahmad R, Alhashmi G, Ajlan A, Eldeek B. Impact of high-fidelity transvaginal ultrasound simulation for radiology on residents' performance and satisfaction. Acad Radiol. 2015;22(2):234–9. https://doi.org/10.1016/j.acra.2014.09.006. Chao C, Chalouhi GE, Bouhanna P, Ville Y, Dommergues M. Randomized clinical trial of virtual reality simulation training for transvaginal gynecologic ultrasound skills. J Ultrasound Med. 2015;34(9):1663–7. https://doi.org/10.7863/ultra.15.14.09063. Girzadas DV Jr, Antonis MS, Zerth H, et al. Hybrid simulation combining a high fidelity scenario with a pelvic ultrasound task trainer enhances the training and evaluation of endovaginal ultrasound skills. Acad Emerg Med. 2009;16(5):429–35. https://doi.org/10.1111/j.1553-2712.2009.00399.x. Tolsgaard MG, Ringsted C, Rosthøj S, et al. The effects of simulation-based transvaginal ultrasound training on quality and efficiency of care: a multicenter single-blind randomized trial. Ann Surg. 2017;265(3):630–7. https://doi.org/10.1097/SLA.0000000000001656. Grantcharov T, Reznick R. Teaching procedural skills. Br Med J. 2008;336:1129–31. https://doi.org/10.1136/bmj.39517.686956.47. Janssens S, Beckmann M, Bonney D. Introducing a laparoscopic simulation training and credentialing program in gynaecology: an observational study. Aust N Z J Obstet Gynaecol. 2015;55:374–8. https://doi.org/10.1111/ajo.12355. Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9 Suppl):S63–7. https://doi.org/10.1097/00001888-199009000-00045. Malouf D. How to teach adults in a fun and exciting way (Vol. 2nd). Crows Nest: Allen & Unwin; 2003. Hainsworth D. Instructional methods. In: Bastaable S, editor. Nurse as educator: principles of teaching and learning for nursing practice. 3rd ed. Boston: Jones and Bartlett; 2008. p. 473–511. Wearne, S. (Producer). 2011, 1/01). Teaching procedural skills in general practice. Australian Family Physician. Retrieved from http://www.racgp.org.au/afp. Accessed 12 Oct 2019. Ker J, Bradley P. Simulation in medical education. In: Swanwick T, editor. Understanding Medical Education: Evidence, Theory and Practice. West Sussex: Wiley-Blackwell; 2010. p. 164–80. Tolsgaard MG, Ringsted C, Dreisler E, et al. Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology. Ultrasound Obstet Gynecol. 2014;43(4):437–43. https://doi.org/10.1002/uog.13198. International Society of Ultrasound in Obstetrics and Gynecology Recommendations. Ultrasound Obstet Gynecol 2013; 2013. https://doi.org/10.1002/uog.13208. Published online in Wiley Online Library. Bhoopatkar H, Wearn A, Vnuk A. Medical students’ experience of performing female pelvic examinations: Opportunities and barriers. Aust N Z J Obstet Gynaecol. 2017;57(5):514–9. https://doi.org/10.1111/ajo.12634. Tolsgaard MG, Ringsted C, Dreisler E, et al. Sustained effect of simulation-based ultrasound training on clinical performance: a randomized trial: Simulation-based training. Ultrasound Obstet Gynecol. 2015;46(3):312–8. https://doi.org/10.1002/uog.14780. Feldman LS, Sherman V, Fried GM. Using simulators to assess laparoscopic competence: Ready for widespread use? Surgery. 2004;135(1):28–42. https://doi.org/10.1016/S0039-6060(03)00155-7. McGaghie WC, Issenberg SB, Barsuk JH, Wayne DB. A critical review of simulation-based mastery learning with translational outcomes. Med Educ. 2014;2014(48):375–85. https://doi.org/10.1111/medu.12391. Lewiss RE, Hoffmann B, Beaulieu Y, Phelan MB. Point-of-care ultrasound education: the increasing role of simulation and multimedia resources. J Ultrasound Med. 2014;33(1):27–32. https://doi.org/10.7863/ultra.33.1.27. Mitchell R, Regan-Smith M, Fisher MA, Knox I, Lambert DR. A new measure of the cognitive, metacognitive, and experiential aspects of residents' learning. Acad Med. 2009;84(7):918–26. https://doi.org/10.1097/ACM.0b013e3181a85609. van Hove PD, Tuijthof GJ, Verdaasdonk EG, et al. Objective assessment of technical surgical skills. Br J Surg. 2010;97:972–87. Madsen ME, Nørgaard LN, Tabor A, Konge L, Ringsted C, Tolsgaard MG. The predictive value of ultrasound learning curves across simulated and clinical settings. J Ultrasound Med. 2017;36:201–8. https://doi.org/10.7863/ultra.16.01037.