Point of care obstetric ultrasound knowledge retention among mid-wives following a training program: a prospective cohort pilot study

Abstract

Background Obstetric ultrasound has become a routine part of antenatal care in many parts of the world including low income settings. However, there is a shortage of radiologists and sonographers to perform routine obstetric scans in many areas especially in the rural settings of low income countries, despite having equipment available to do this. As a result, Point of care ultrasound (POCUS) has been suggested to bridge this gap by training other health workers such as midwives to perform basic obstetric ultrasound as part of their clinical care. Methods It was a prospective cohort pilot study in which trained midwives in point of care obstetric ultrasound were followed up at 6 months post training to assess their knowledge retention. Eleven trained midwives were purposively selected and followed up for knowledge retention. These were trained for 6 weeks and were given a knowledge assessment immediately after training, then given an assessment at 6 months following training. Data was analyzed using SPSS. Wilcoxon signed rank test was used to compare assessments and perceived knowledge as well as Spearman correlation to test the relationship between the number of scans performed and exam assessments, knowledge and exam assessments, and number of scans and knowledge. Results There were eleven midwives, all female with an average age of 42.3 years. The mean exam score (out of 50) was 44.2 at the end of the training and 42.9 at 6-months follow up. The midwives demonstrated higher perceived knowledge at the end of the training when compared to the 6-months follow up. However, this perceived higher knowledge was not statistically significant when correlated with the exam scores either at the end of the training or at the follow up of 6 months. Conclusion This pilot study has demonstrated that training midwives in point of care obstetric ultrasound can result into acceptable levels of knowledge retention that assist the midwives to apply this knowledge when making routine clinical decisions in relation to pregnant women.

Shaping ultrasound in midwifery: towards an evidence-based training framework for enhanced prenatal care

“…A critical component of the training involves fostering effective communication skills and professional conduct during patient interactions, emphasizing the significance of the midwife's role in prenatal ultrasound examination. This aspect of training underscores the importance of patientcentered care and safety [24,25].…”

“…[15] Evaluation of point-of-care ultrasound training for midwives MSc. Thesis 2021 Uys, N. [41] A health systems engineering approach to meeting the demand for skilled foetal ultrasound services in the Boland/Overberg public health district Midwives, given their direct involvement in the care of pregnant women, emerge as the ideal candidates for the acquisition and application of obstetric ultrasound skills, with the primary goals of augmenting clinical care, expediting the management of expectant mothers, and reducing incidences of preventable deaths [22,[24][25][26].…”

“…In addition, ultrasonography serves as a more accurate alternative to traditional methods of gestational age estimation, such as abdominal palpation and calculation based on the last menstrual period [25]. This non-invasive, cost-effective approach not only enhances the accuracy of physical assessments and clinical decision-making but also facilitates timely referrals to specialized care centers [20,23,24,28].…”

“…Key biometric indicators include the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), crown-rump length (CRL), and femur length (FL) [16,25,29]. In addition, midwives are educated on identifying fetal presentation, vitality, and number, as well as placental positioning and amniotic fluid volume [24].…”

“…The incorporation of case-based seminars facilitates the application of theoretical knowledge to real-world scenarios, fostering critical thinking and dialogue [28,31]. Course formats vary, with some programs delivering theoretical content in-person, while others explore the efficacy of digital platforms or self-guided study through electronic modules [18,22,24].…”