Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College, London, UK.
Prenat Diagn. 2021 Jan;41(2):271-277. doi: 10.1002/pd.5855. Epub 2020 Nov 5.
Widely accepted, validated and objective measures of ultrasound competency have not been established for clinical practice. Outcomes of training curricula are often based on arbitrary thresholds, such as the number of clinical cases completed. We aimed to define metrics against which competency could be measured.
We undertook a prospective, observational study of obstetric sonographers at a UK University Teaching Hospital. Participants were either experienced in fetal ultrasound (n = 10, >200 ultrasound examinations) or novice operators (n = 10, <25 ultrasound examinations). We recorded probe motion data during the performance of biometry on a commercially available mid-trimester phantom.
We report that Dimensionless squared jerk, an assessment of deliberate hand movements, independent of movement duration, extent, spurious peaks and dimension differed significantly different between groups, 19.26 (SD 3.02) for experienced and 22.08 (SD 1.05, p = 0.01) for novice operators, respectively. Experienced operator performance, was associated with a shorter time to task completion of 176.46 s (SD 47.31) compared to 666.94 s (SD 490.36, p = 0.0004) for novice operators. Probe travel was also shorter for experienced operators 521.23 mm (SD 27.41) versus 2234.82 mm (SD 188.50, p = 0.007) when compared to novice operators.
Our results represent progress toward an objective assessment of technical skill in obstetric ultrasound. Repeating this methodology in a clinical environment may develop insight into the generalisability of these findings into ultrasound education.
目前尚未建立针对临床实践的广泛认可、经过验证且客观的超声能力衡量标准。培训课程的结果通常基于任意阈值，例如完成的临床病例数量。我们旨在确定可以衡量能力的指标。
我们对英国一所大学教学医院的产科超声医师进行了前瞻性、观察性研究。参与者要么是具有丰富胎儿超声经验的（n = 10，超过 200 次超声检查），要么是新手操作人员（n = 10，少于 25 次超声检查）。我们在商业上可用的中期胎儿模型上记录了在执行生物测量时探头的运动数据。
我们报告说，无因次平方急动度是对手部有意运动的评估，与运动持续时间、幅度、虚假峰值和维度无关，两组之间的差异具有统计学意义，经验丰富的操作人员为 19.26（SD 3.02），而新手操作人员为 22.08（SD 1.05，p = 0.01）。经验丰富的操作人员的操作，与完成任务的时间更短相关，为 176.46 秒（SD 47.31），而新手操作人员为 666.94 秒（SD 490.36，p = 0.0004）。与新手操作人员相比，经验丰富的操作人员的探头移动距离也更短，为 521.23 毫米（SD 27.41），而新手操作人员为 2234.82 毫米（SD 188.50，p = 0.007）。
我们的研究结果代表了在产科超声技术技能的客观评估方面取得的进展。在临床环境中重复这种方法可能会深入了解这些发现在超声教育中的普遍性。
