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Improved Procedure Performance with Practice of Ultrasound Guidance Targeting Tasks

Purpose: To determine if repetitive practice of ultrasound guidance targeting tasks improves procedural skill in a simulated setting

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,

General Information

Patient Care,
Clinical Focus
Maternal-Fetal Medicine,

Author Information

Joshua Nitsche, MD, PhD, Wake Forest School of Medicine; Sarah Conrad, MD; Sarah Hoopes, MD; Meredith Carrel, MD; Katherine Bebeau, MD; Brian Brost, MD

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