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评估无超声经验者的简短标准化产科超声培训计划。

Assessment of a Brief Standardized Obstetric Ultrasound Training Program for Individuals Without Prior Ultrasound Experience.

机构信息

University of Rochester School of Medicine and Dentistry.

Department of Imaging Sciences, University of Rochester Medical Center.

出版信息

Ultrasound Q. 2023 Sep 1;39(3):124-128. doi: 10.1097/RUQ.0000000000000626.

Abstract

Obstetric volume sweep imaging (OB VSI) is a simple set of transducer movements guided by external body landmarks that can be taught to ultrasound-naive non-experts. This approach can increase access to ultrasound in rural/low-resources settings lacking trained sonographers. This study presents and evaluates a training program for OB VSI. Six trainees without previous formal ultrasound experience received a training program on the OB VSI protocol containing focused didactics and supervised live hands-on ultrasound scanning practice. Trainees then independently performed 194 OB VSI examinations on pregnancies >14 weeks with known prenatal ultrasound abnormalities. Images were reviewed by maternal-fetal medicine specialists for the primary outcome (protocol deviation rates) and secondary outcomes (examination quality and image quality). Protocol deviation was present in 25.8% of cases, but only 7.7% of these errors affected the diagnostic potential of the ultrasound. Error rate differences between trainees ranged from 8.6% to 53.8% ( P < 0.0001). Image quality was excellent or acceptable in 88.2%, and 96.4% had image quality capable of yielding a diagnostic interpretation. The frequency of protocol deviations decreased over time in the majority of trainees, demonstrating retention of training program over time. This brief OB VSI training program for ultrasound-naive non-experts yielded operators capable of producing high-quality images capable of diagnostic interpretation after 3 hours of training. This training program could be adapted for use by local community members in low-resource/rural settings to increase access to obstetric ultrasound.

摘要

产科容积扫查成像(OB VSI)是一种简单的探头运动方法,通过外部身体标志进行引导,即使是非专业的超声初学者也可以学习。这种方法可以增加在缺乏训练有素的超声技师的农村/资源匮乏环境中获得超声的机会。本研究提出并评估了 OB VSI 的培训计划。六名没有之前正式超声经验的学员接受了 OB VSI 方案的培训计划,该计划包含集中教学和监督现场实际操作。然后,学员们独立对 194 例 14 周以上的妊娠进行了 OB VSI 检查,这些妊娠均有已知的产前超声异常。图像由母胎医学专家进行评估,以评估主要结局(方案偏离率)和次要结局(检查质量和图像质量)。在 25.8%的病例中存在方案偏离,但只有 7.7%的这些错误影响了超声的诊断潜力。学员之间的错误率差异从 8.6%到 53.8%不等(P < 0.0001)。88.2%的图像质量为优秀或可接受,96.4%的图像质量能够进行诊断解读。在大多数学员中,随着时间的推移,方案偏离的频率降低,这表明培训计划随着时间的推移得到了保留。这个简短的 OB VSI 培训计划适用于超声初学者非专家,经过 3 小时的培训,学员能够获得高质量的、能够进行诊断解读的图像。这个培训计划可以适应当地社区成员在资源匮乏/农村地区使用,以增加产科超声的可及性。

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