Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
Center of Fetal Medicine and Ultrasound, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark.
Ultrasound Obstet Gynecol. 2020 Apr;55(4):523-529. doi: 10.1002/uog.20362.
To explore the effects of simulation-based ultrasound training on the accuracy of fetal weight estimation in the third trimester among obstetricians with different levels of clinical experience.
This was a multicenter, randomized pre-post-test practical trial conducted between March 2016 and January 2018. Obstetricians with different levels of clinical experience were randomized to either simulation-based ultrasound training focusing on fetal weight scans or no intervention. Participants completed two scans in pregnant women at term to establish baseline accuracy of fetal weight estimation. Another two scans were performed at follow-up. Accuracy was defined by the percentage difference between estimated fetal weight and actual birth weight. Ultrasound image quality was rated by two expert raters.
Seventy participants with different levels of clinical experience completed the study. Adjusting for clinical experience, the intervention group demonstrated an improvement in measurement accuracy of 31.9% (95% CI, 6.9-50.1%) (P = 0.02), whereas the control group did not improve (relative difference, 13.1% (95% CI, -17.9 to 55.9%); P = 0.45). The change in accuracy was significantly different between the groups (P = 0.02) and independent of clinical experience (P = 0.54). Image-quality scores improved by a mean of 1.2 (95% CI, 0.4-2.1) (P < 0.01) in the intervention group, with no change in the control group (mean difference, 0.1 (95% CI, -0.8 to 1.0); P = 0.78). There was a strong negative correlation between time spent using the simulator and clinical experience (r = -0.70, P = 0.0001).
Simulation-based ultrasound training improved accuracy and image quality when performing fetal weight estimation in women at term, independent of obstetricians' clinical experience. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
探讨基于模拟的超声培训对不同临床经验水平的产科医生在孕晚期胎儿体重估计准确性的影响。
这是一项多中心、随机前后测试的实用试验，于 2016 年 3 月至 2018 年 1 月进行。不同临床经验水平的产科医生被随机分为基于模拟的超声培训组（重点关注胎儿体重扫描）或无干预组。参与者在孕妇足月时完成两次扫描，以建立胎儿体重估计的基线准确性。在随访时进行另外两次扫描。准确性定义为估计胎儿体重与实际出生体重的百分比差异。由两位专家评分员对超声图像质量进行评分。
70 名具有不同临床经验的参与者完成了该研究。调整临床经验后，干预组的测量准确性提高了 31.9%（95%置信区间，6.9-50.1%）（P=0.02），而对照组则没有提高（相对差异，13.1%（95%置信区间，-17.9 至 55.9%）；P=0.45）。两组间的准确性变化差异有统计学意义（P=0.02），且与临床经验无关（P=0.54）。干预组的图像质量评分平均提高了 1.2（95%置信区间，0.4-2.1）（P<0.01），对照组则没有变化（平均差异，0.1（95%置信区间，-0.8 至 1.0）；P=0.78）。使用模拟器的时间与产科医生的临床经验呈强烈负相关（r=-0.70，P=0.0001）。
基于模拟的超声培训可提高在孕妇足月时进行胎儿体重估计的准确性和图像质量，与产科医生的临床经验无关。版权所有©2019ISUOG。由 John Wiley & Sons Ltd 出版。
