Tolsgaard M G, Ringsted C, Dreisler E, Nørgaard L N, Petersen J H, Madsen M E, Freiesleben N L C, Sørensen J L, Tabor A
Centre for Clinical Education, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
Department of Obstetrics and Gynecology, Juliane Marie Centre, Rigshospitalet, Capital Region and University of Copenhagen, Copenhagen, Denmark.
Ultrasound Obstet Gynecol. 2015 Sep;46(3):312-8. doi: 10.1002/uog.14780. Epub 2015 Aug 6.
To study the effect of initial simulation-based transvaginal sonography (TVS) training compared with clinical training only, on the clinical performance of residents in obstetrics and gynecology (Ob-Gyn), assessed 2 months into their residency.
In a randomized study, new Ob-Gyn residents (n = 33) with no prior ultrasound experience were recruited from three teaching hospitals. Participants were allocated to either simulation-based training followed by clinical training (intervention group; n = 18) or clinical training only (control group; n = 15). The simulation-based training was performed using a virtual-reality TVS simulator until an expert performance level was attained, and was followed by training on a pelvic mannequin. After 2 months of clinical training, one TVS examination was recorded for assessment of each resident's clinical performance (n = 26). Two ultrasound experts blinded to group allocation rated the scans using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale.
During the 2 months of clinical training, participants in the intervention and control groups completed an average ± SD of 58 ± 41 and 63 ± 47 scans, respectively (P = 0.67). In the subsequent clinical performance test, the intervention group achieved higher OSAUS scores than did the control group (mean score, 59.1% vs 37.6%, respectively; P < 0.001). A greater proportion of the intervention group passed a pre-established pass/fail level than did controls (85.7% vs 8.3%, respectively; P < 0.001).
Simulation-based ultrasound training leads to substantial improvement in clinical performance that is sustained after 2 months of clinical training. © 2015 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
研究与仅接受临床培训相比,初始的基于模拟的经阴道超声检查(TVS)培训对妇产科(Ob-Gyn)住院医师临床操作的影响,在其住院医师培训2个月时进行评估。
在一项随机研究中,从三家教学医院招募了无超声检查经验的新妇产科住院医师(n = 33)。参与者被分配到先进行基于模拟的培训然后进行临床培训的组(干预组;n = 18)或仅进行临床培训的组(对照组;n = 15)。基于模拟的培训使用虚拟现实TVS模拟器进行,直至达到专家操作水平,随后在盆腔模型上进行培训。经过2个月的临床培训后,记录每位住院医师的一次TVS检查以评估其临床操作(n = 26)。两名对分组情况不知情的超声专家使用超声技能客观结构化评估(OSAUS)量表对扫描结果进行评分。
在2个月的临床培训期间,干预组和对照组参与者分别平均完成了58 ± 41次和63 ± 47次扫描(P = 0.67)。在随后的临床操作测试中,干预组的OSAUS得分高于对照组(平均得分分别为59.1%和37.6%;P < 0.001)。干预组通过预先设定的及格/不及格水平的比例高于对照组(分别为85.7%和8.3%;P < 0.001)。
基于模拟的超声培训可使临床操作有显著改善,且在2个月的临床培训后仍能保持。© 2015作者。《妇产科超声》由John Wiley & Sons Ltd代表国际妇产科超声学会出版。