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Dan Med J. 2018 Feb;65(2). pii: B5445.

Assessment and learning of ultrasound skills in Obstetrics & Gynecology

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Ultrasound is a core skill in obstetrics-gynecology, but is highly operator-dependent. The evidence supporting the use of different methods for assessment and training of ultrasound skills was examined from different perspectives through a series of explorative and experimental studies.
We found that ultrasound performance of trainees in obstetrics-gynecology depended on a combination of motor skills, visual skills, and cognitive skills. We then established international multispecialty consensus on an assessment instrument designed to evaluate ultrasound skills. The validity evidence of assessments made using this instrument was then examined using empirical data on the performances of obstetrician-gynecologists with different levels of clinical experience. There was evidence to suggest that technical aspects of trainee performance may need improvement, and that simulation-based ultrasound training may play a role by allowing trainees to achieve mastery levels prior to their clinical training. We found that the use of simulation-based ultrasound training led to immediate as well as sustained improvements in trainees' performances with patients. Moreover, simulation-based ultrasound training led to improvements in patient-reported discomfort, perceived safety, and confidence in the ultrasound operator. From an organizational perspective, we found evidence that providing initial simulation-based ultrasound training combined with clinical training reduced the need for supervised practice and repeated patient examinations. This evidence supported the hypothesis that simulation-based medical education can act as preparation for future learning. Finally, by taking a health economics perspective, we examined how ultrasound training could be linked to monetary costs, and demonstrated how training efficiency could be doubled using collaborative learning without negative consequences.

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