Chawla Latika, Kumar Rajan, Rajaram Shalini, Rao Shalinee, Dubey Kanak, Bahadur Anupama, Gaurav Amrita, Khoiwal Kavita, Mundra Rajlaxmi, Kumari Om, Gill Poonam, Chaturvedi Jaya
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
Department of Continuous Professional Development, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
Int J Gynaecol Obstet. 2025 Apr;169(1):267-273. doi: 10.1002/ijgo.16076. Epub 2024 Dec 4.
Current postgraduate curriculum in India lacks practical training in ultrasound for residents in obstetrics and gynecology. The objective of this study was to develop and assess impact of a capacity building program utilizing clinical teaching and simulation to enhance knowledge and skills of residents at a healthcare facility in India.
A training program comprising of 14 modules on basic obstetric ultrasounds was created over 3 months. These modules, validated by fetal medicine experts, underwent a pilot study for face validity. A total of 18 newly enrolled junior residents without prior ultrasound experience were recruited. A two-day workshop included interactive module sessions and 6 h and 30 min of hands-on training using an obstetric simulator. Pre- and post-tests consisting of 50 multiple-choice questions (MCQs) assessed knowledge. Follow-up assessments were carried out at 1 and 3 months. Skill assessment at the third month was conducted using an objective structured practical examination (OSPE), alongside image submission by residents.
There was significant improvement in marks over time, with a mean pretest score of 24 ± 2.7 out of 50 marks, post-test score of 36.81 ± 2.86 and stable scores (34.6 ± 3.21, 34.4 ± 2.96) during follow-up reviews. OSPE scores at third month averaged at 21.47 ± 2.3 (maximum marks 30); image assessment scores averaged at 83 ± 8.62 (maximum marks 100). Participant feedback indicated a positive response to all program aspects (practicality, content and structured training). Confidence levels in performing clinical ultrasound improved significantly after attending the module (P < 0.0001).
Simulation with clinical teaching effectively enhanced knowledge and skills of residents, fostering confidence in performing basic obstetric ultrasounds early on in their residency. Integrating similar capacity building initiatives into residency training programs can improve healthcare delivery by ensuring a well prepared cadre of doctors skilled in obstetric ultrasounds.
印度当前的研究生课程缺乏针对妇产科住院医师的超声实践培训。本研究的目的是开发并评估一项能力建设项目的影响,该项目利用临床教学和模拟来提高印度一家医疗机构中住院医师的知识和技能。
在3个月内创建了一个由14个关于基本产科超声模块组成的培训项目。这些模块经胎儿医学专家验证,进行了内容效度的预试验。共招募了18名新入学且无超声经验的初级住院医师。为期两天的研讨会包括互动模块课程以及使用产科模拟器进行6小时30分钟的实践培训。由50道多项选择题组成的前测和后测评估知识水平。在1个月和3个月时进行随访评估。在第三个月使用客观结构化实践考试(OSPE)进行技能评估,并让住院医师提交图像。
随着时间推移,成绩有显著提高,前测平均成绩为50分中的24±2.7分,后测成绩为36.81±2.86分,随访评估期间成绩稳定(34.6±3.21分,34.4±2.96分)。第三个月的OSPE平均成绩为21.47±2.3分(满分30分);图像评估平均成绩为83±8.62分(满分100分)。参与者反馈表明对项目的所有方面(实用性、内容和结构化培训)都有积极回应。参加该模块后,进行临床超声检查的信心水平显著提高(P<0.0001)。
临床教学模拟有效地提高了住院医师的知识和技能,增强了他们在住院医师培训早期进行基本产科超声检查的信心。将类似的能力建设举措纳入住院医师培训项目,可以通过确保培养出一批精通产科超声检查的医生来改善医疗服务。