Background: Due to a
decrease in ultrasound guided invasive procedures other training methods are
required to insure all MFM fellows graduate with sufficient skill to independently
perform these procedures.
Methods: 1st year
medical students either practiced the targeting tasks during 4 weekly one hour
sessions (training group) or had no training (controls). Afterward all
performed a simulated amniocentesis (AC) and chorionic villus sampling
(CVS). Procedures were timed and the presence of the following recorded:
1) proper angle of entry, 2) excessive (>0.5 cm) needle movement during
aspiration, and 3) critical errors (touching the fetus during AC, touching the
opposite uterine wall or amniotic cavity during CVS).
Results: There
were 22 in the training group and 15 controls. AC completion time was
140±28 seconds (sec) vs. 211±62 sec in the training and control groups,
respectively (p(0.0%) vs. 1/15 (6.7%), 3/22 (13.6%) vs. 7/15 (46.7%), and 6/22
27.3%) and 8/15 (53.3%) had improper angles, excessive needle movement (p(9.1%)
vs. 10/15 (66.7%), 1/22 (4.5%) vs. 8/15 (53.3%), and 3/22 (13.6%) vs. 9/15
(60.0%)had improper angles, excessive needle movement, and critical errors,
respectively (all p<0.05).
Discussions: Repetitive practice of
the targeting tasks improved student performance in simulated AC and CVS.
There appeared to be greater benefit for CVS performance. Regular
practice of the targeting tasks will likely benefit MFM fellow training.
Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Patient Care, GME, Assessment, Simulation, Maternal-Fetal Medicine,
Joshua Nitsche,
MD, PhD, Wake
Forest School of Medicine; Sarah Conrad, MD;
Sarah Hoopes,
MD; Meredith
Carrel, MD;
Katherine Bebeau,
MD; Brian
Brost, MD
