Byford Sally, Janssens Sarah, Cook Rachel
Mater Health, Mater Hospital, Brisbane, Australia.
Mater Education, Mater Hospital, Brisbane, Australia.
Adv Simul (Lond). 2021 Jan 12;6(1):1. doi: 10.1186/s41077-020-00152-y.
Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap.
To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars.
The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests.
Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2-8.9, p < 0.05) and 32.5 (95% CI 26.4-38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4-2.5, p < 0.05) and 2.1 (95% CI 1.5-2.7, p < 0.05) respectively.
The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.
经阴道超声检查（TVUS）因其私密性质，培训机会有限；然而，TVUS是早期妊娠评估的重要组成部分。模拟可以弥补这一学习差距。
描述并衡量经阴道超声模拟程序对产科住院医师的影响。
经阴道超声模拟训练（TRUSST）课程包括使用虚拟现实经阴道模拟器（ScanTrainer，Medaphor）进行支持性练习以及沟通技巧训练，以帮助产科住院医师获得所需能力，从而准确、全面地护理患有早期妊娠并发症的女性。通过问卷调查评估学员在实时经阴道扫描方面的经验。通过培训前后自我报告的信心水平以及使用超声技能客观结构化评估（OSAUS）和澳大利亚和新西兰皇家妇产科医师学院修改后的评估分数进行客观的培训前后评估来进行项目评估。使用配对t检验比较定量数据。
15名产科住院医师完成了该课程。学员进行实时经阴道超声检查的次数较少。参与者报告称，培训后进行TVUS检查的信心水平有所提高：培训前平均得分为1.6/5，培训后平均得分为3/5。培训后，OSAUS和RANZCOG分数的客观评估均有显著改善；平均提高分数分别为7.6分（95%置信区间6.2 - 8.9，p < 0.05）和32.5分（95%置信区间26.4 - 38.6，p < 0.05）。值得注意的是，系统方法和记录方面的分数提高最为显著：分别为1.9分（95%置信区间1.4 - 2.5，p < 0.05）和2.1分（95%置信区间1.5 - 2.7，p < 0.05）。
基于模拟的培训课程的实施提高了TVUS扫描的信心和能力，特别是在系统方法和记录方面。
