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

Abstract

Background 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. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods 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. Results 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. Conclusion 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.

Ultrasound Simulation for Training Trainees when the Luxury Becomes Essential: Opinion and Evidence Obtained during the Latvian Research Council Project Implementation

“…Our small pilot study clearly demonstrates the potential efficiency of a high-fidelity simulator, for improving the clinical performance and confidence of the participants in accomplishing sonographic techniques on real patients, regarding assesment of uterine cervix in pregnant woman. This corresponds with the findings of Byford et al [9] study when even unexperienced trainees had an increase in confidence.…”

“…Historically ultrasound methods have been taught by hands-on practical manner training on patients or volunteers, but ethical issues of multiple unnecessary vaginal scans in gynecologic settings and As Low As Reasonably Achievable (ALARA) principle in obstetrics make these clinical training approaches less relevant. Moreover, the learning ability of the trainees, their pace of assimilating and incorporating knowledge and practical competence are very variable in such a setting [ 8 , 9 ].…”

Trans-vaginal ultrasound simulation: An exploratory qualitative research study focused on the end-users perception of learning

“…Another study of twenty-four participants limited perception to questionnaire analysis [14]. Another study of 15 doctors, showed improved confidence, more systematic approach and documentation [16] but also limited perceptions to questionnaire analysis. A similar study reported questionnaire responses from 28 participants following a four hour TVUS simulation course, showing that participants believed that simulation training applied to clinical practice and that their performance would improve after simulation training [15]; a final study of medical students showed enhanced clarity and knowledge following TVUS simulation training [17].…”

“…Of the publications to date that studied trainee's perspectives of TVUS simulation training, most are quantitative studies using questionnaires or self-assessed confidence scores [10,[13][14][15][16][17] with one mixed methods study [12]. In contrast, qualitative research allows use of open-ended questions that aim to explore what is important to the trainee themselves.…”

Objective structured assessment ultrasound skill scale for hyomental distance competence – psychometric study

“…OSAUS scale was used as an assessment tool during the implementation of a simulation training in emergent Focused Abdominal Sonography in Trauma (eFAST) [ 22 ] and in transvaginal ultrasound [ 44 ]. The scale was also able to discriminate competence group with a good reliability in the assessment of point-of-care ultrasonography.…”