Purpose: The objective of this study assess resident confidence in obstetric ultrasound as per ACGME milestones and CREOG objectives, and factors associated with confidence performing US independently.
Background: Performing obstetric ultrasound(US) is an ACGME
milestone, a CREOG objective, and a CREOG core procedure, though many programs
lack formal US curricula.
Methods: CREOG coordinator listserve used to distribute
27-question anonymous e-survey in 3/2018 to OBGYN residents in US and Puerto
Rico. Questions included experience performed growth US(gUS) and anatomy
US(aUS) as primary sonographer, performing US independently, and for 4th year
residents only, comfort performing US post-residency. Bivariate statistics
compared residents comfortable performing US independently to those who were
not.
Results: 417 residents completed the survey: 88% were female,
75% from academic programs, and nearly 50% were post-graduate year(PGY)
3&4. While 89.1% had been primary sonographer for gUS, only 63% felt
comfortable performing independently. Of chief residents, 14% didn’t feel
comfortable performing gUS post-residency. In contrast, 60.9% had been primary
sonographer for aUS, only 20.1% felt comfortable performing aUS independently,
and 68.8% didn’t feel comfortable performing aUS post-residency.
Residents were more likely to feel comfortable performing gUS independently in
PGY3&4 (p< 0.01) and after longer MFM rotations(p=0.02), and less likely
when MFM fellows were present (p=0.02). Residents not comfortable performing
aUS were twice as likely to have MFM fellows (p< 0.01), and less likely to
be PGY3&4(p< 0.01).
Discussions: significant percentage of residents are not
comfortable with their ultrasound skills. This data further emphasizes the need
for structured US curricula and simulation.
Topics: CREOG & APGO Annual Meeting, 2020, Resident, Faculty, Residency Director, Patient Care, Practice-Based Learning & Improvement, GME, Assessment, Simulation, Maternal-Fetal Medicine, General Ob-Gyn,
Sarah Dotters-Katz,
MD, MHPE; Duke; Matthew Grace, MD; Katie Propst,
MD; Jeffrey Kuller, MD; Brita Boyd, MD; Sarah
Ellestad, MD