Hartup Lindsay A, Lewis Ariana L, Medrano Gabriel A
Department of Obstetrics and Gynecology, University of Texas Health San Antonio, San Antonio, Texas, USA.
Clin Teach. 2025 Feb;22(1):e70019. doi: 10.1111/tct.70019.
Transvaginal ultrasound (TVUS) is the primary imaging modality in obstetrics and gynaecology (OB/GYN); however, it is highly user dependent. TVUS education for medical students is often sporadic and inconsistent. Simulation-based training (SBT) is a well-established innovation for learners to safely develop proficiency.
A TVUS curriculum was developed using motivational theory and SBT. Five 2-h educational sessions were held at the beginning of five OB/GYN clerkships, including didactics on TVUS indications/technique, TVUS simulation and a pathology competition. A digital nine-question survey assessing students' experience and comfort level with TVUS was administered after the clerkship. Students who completed their clerkship prior to the curriculum being delivered or were not present for it were administered the same survey. These students served as the control group.
Eighty-nine of 111 (80.1%) students who participated in the curriculum and 77/211 (36.4%) who did not participate completed the postclerkship survey. Twenty-seven of 84 (32.1%) in the simulation group who observed a TVUS performed one during their OB/GYN clerkship compared to 13/76 (17.1%) students in the control group (p = 0.04). Students present for the TVUS curriculum reported greater understanding of the TVUS they observed during their OB/GYN clerkship, OR 3.11 [1.71, 5.78] (p < 0.001); increased comfort recognising normal anatomy, OR 6.63 [3.55, 12.74] (p < 0.001); and gynecologic pathology, OR 7.56 [4.09, 14.33] (p < 0.001), on TVUS.
Implementation of TVUS simulation curricula should be considered in undergraduate medical education given the potential to improve educational experience during the OB/GYN clerkship.
经阴道超声(TVUS)是妇产科(OB/GYN)的主要成像方式;然而,它高度依赖使用者。医学生的TVUS教育往往零散且不一致。基于模拟的培训(SBT)是一种成熟的创新方法,可让学习者安全地提高熟练程度。
利用动机理论和SBT开发了一个TVUS课程。在五个妇产科实习开始时,举办了五次2小时的教育课程,包括关于TVUS适应症/技术的教学、TVUS模拟和病理竞赛。实习结束后,进行了一项包含九个问题的数字调查,评估学生对TVUS的体验和舒适度。在课程实施之前完成实习或未参加课程的学生也接受了同样的调查。这些学生作为对照组。
参加课程的111名学生中有89名(80.1%),未参加课程的211名学生中有77名(36.4%)完成了实习后调查。模拟组中观看过TVUS的84名学生中有27名(32.1%)在妇产科实习期间进行了一次TVUS操作,而对照组的76名学生中有13名(17.1%)进行了操作(p = 0.04)。参加TVUS课程的学生表示,他们对在妇产科实习期间观察到的TVUS有了更深入的理解,比值比为3.11 [1.71, 5.78](p < 0.001);识别正常解剖结构的舒适度提高,比值比为6.63 [3.55, 12.74](p < 0.001);以及对TVUS上妇科病理学的识别舒适度提高,比值比为7.56 [4.09, 14.33](p < 0.001)。
鉴于在妇产科实习期间有改善教育体验的潜力,本科医学教育应考虑实施TVUS模拟课程。