Ultrasound Assessment of Fetal Head Position

Abstract

OBJECTIVE: We developed a 1-hour multimedia conference to educate Obstetrics and Gynecology residents on the techniques of digital and ultrasound assessment of fetal head position. We evaluated the curriculum by assessing its impact on resident performance and confidence before and after the conference. METHODS: The conference included a 15-minute demonstration video and a supervised skill practice using a simulation mannequin and pelvis. Participants were asked to submit digital documentation of one attempt of ultrasound assessment of fetal head position on a laboring patient. EVALUATION: Eleven residents (PGY-1, n=5; PGY-3, n=6) successfully completed the conference and surveys. There was a nonsignificant increase in the resident documentation of fetal head position as part of the labor cervical exam in the 3 months following the start of the conference compared to the same 3 months from the year prior (25.6% versus 20%, P=.48). Mean confidence in the ability to identify fetal head position (5.1 versus 6.9, P=.004), rotate the fetal head (3.5 versus 5.1, P=.013), safely apply a vacuum or forceps (3.9 versus 4.5, P=.054), and use ultrasonography to assist in identification of fetal head position (5.7 versus 6.4, P=.09) improved following the conference. DISSEMINATION: The demonstration video was accepted for presentation at the CREOG & APGO Film Festival 2017 and will be submitted to the AAMC MedEdPORTAL. The curriculum evaluation results will be submitted to the Journal of Graduate Medical Education. REFLECTIVE CRITIQUE: We will plan to enroll more residents into the study over the course of the next year.