American Society for Reproductive Medicine, Birmingham, Alabama.
American Society for Reproductive Medicine, Birmingham, Alabama; Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Fertil Steril. 2021 Apr;115(4):852-859. doi: 10.1016/j.fertnstert.2020.10.056. Epub 2020 Dec 23.
To assess the value of the American Society for Reproductive Medicine Embryo Transfer Certificate Course in confidence and skill building for performing a live embryo transfer (ET).
Prospective cohort study.
Two-day simulation workshops of reproductive endocrine and infertility (REI) fellows from American Board of Obstetrics and Gynecology-approved training programs, using four different uterine models (A-D).
PATIENT(S): None.
INTERVENTION(S): Didactic and hands-on simulation training program.
MAIN OUTCOME MEASURE(S): Primary outcomes included ET simulation scores of all exercises analyzed at various points of the training and self-assessed confidence before and after the completion of the Embryo Transfer Certificate Course based on a 6-point Likert scale and association of both with extent of prior live ET experience and year of fellowship.
RESULT(S): Data were collected for 78 REI fellows who completed the Embryo Transfer Certificate Course and demonstrated significant improvements in both skill and confidence. The data for a subset of 58 fellows who performed five direct transfers on both Embryo Transfer Certificate Course uterine models A and B demonstrated significant overall improvement in ET simulation scores between the first and fifth direct transfers. A separate data subset of 57 fellows who performed five afterload transfers for each exercise on all four uterine models demonstrated differences in difficulty among them. Embryo transfer simulation using the uterine A model was consistently the easiest. The ET simulation scores for fellows using the uterine B and C models showed a progressive and significant increase across the five afterload ETs. When using the uterine D model, ET simulation scores increased significantly between the first and second transfers but remained at the same level for the remaining three transfers. Except for uterus A, a significant increase in ET simulation scores between the first and last transfers was observed for fellows overall in all afterload transfers and for those fellows with <50 prior live transfers. Data for all 78 fellows demonstrate a significant gain of self-confidence for all parameters, with the highest overall increase (78%) observed for first-year fellows as well as for fellows of any year with no prior live transfer experience (109%). Fellows with the largest number of prior live ET experience started with higher confidence, which also increased significantly, although they had a lower gain in confidence compared with fellows with less experience.
CONCLUSION(S): The American Society for Reproductive Medicine Embryo Transfer Certificate Course data analysis demonstrates the effectiveness of simulator-based ET training for REI fellows across the 3 years of training, regardless of prior experience with live ET.
评估美国生殖医学学会胚胎移植证书课程对进行活体胚胎移植（ET）的信心和技能提升的价值。
前瞻性队列研究。
接受美国妇产科委员会认证培训计划的生殖内分泌和不孕不育（REI）研究员为期两天的模拟研讨会，使用四种不同的子宫模型（A-D）。
无。
理论和实践模拟培训计划。
主要结果包括在培训的不同时间点分析的所有练习的 ET 模拟得分，以及根据 6 分李克特量表在完成胚胎移植证书课程前后自我评估的信心，并与活体 ET 经验的程度和 fellowship的年限相关联。
为完成胚胎移植证书课程的 78 名 REI 研究员收集了数据，并显示出技能和信心的显著提高。对在胚胎移植证书课程的 A 和 B 型子宫模型上进行五次直接转移的 58 名研究员的子数据集数据表明，在五次直接转移之间，ET 模拟得分有显著的整体提高。对所有四个子宫模型的每个练习进行五次后负荷转移的 57 名研究员的另一个数据子集表明，它们之间存在难度差异。使用子宫 A 模型进行胚胎移植模拟始终是最简单的。使用子宫 B 和 C 模型的研究员的 ET 模拟得分在五次后负荷 ET 中逐渐显著增加。当使用子宫 D 模型时，ET 模拟得分在第一和第二转移之间显著增加，但在其余三次转移中保持相同水平。除子宫 A 外，所有后负荷转移的所有研究员以及前 50 次活体转移经验较少的研究员的第一和最后转移之间的 ET 模拟得分均显著增加。所有 78 名研究员的数据均显示出对所有参数的自我信心显著增强，其中第一年研究员以及任何一年没有活体转移经验的研究员（109%）的总体增强幅度最大。有较多活体 ET 经验的研究员开始时信心较高，尽管与经验较少的研究员相比，他们的信心增长幅度较小，但信心也显著增加。
美国生殖医学学会胚胎移植证书课程数据分析表明，模拟器为基础的 ET 培训对 REI 研究员在 3 年培训期间都有效，无论其是否有活体 ET 的经验。
