Purpose: To bridge the learning gap for performing amniocentesis by implementing a low cost simulator to increase resident proficiency in amniocentesis.
Background: Amniocentesis is an invasive diagnostic procedure performed for evaluation of fetal abnormalities such as chromosomal anomalies or infection. With the advent of non-invasive prenatal screening, amniocentesis is becoming increasingly rare. Consequently, the ability to learn and become proficient at performing amniocenteses during residency is becoming increasingly difficult. As amniocentesis or chorionic villus sampling remain the only means of obtaining a diagnosis of fetal abnormalities, the ability to perform an amniocentesis is important for all OBGYN residents. Simulators serve to bridge the learning gap in healthcare scenarios that are infrequent but high stakes. Most available simulators are complicated or expensive. This low cost, low fidelity amniocentesis and cordocentesis simulator uses supplies that are cheap and easily accessible for any residency program.
Methods: The simulator is created using supplies that can be readily obtained at a hospital or grocery store. Using a Ziploc bag of opaque Jell-O as the pre-amniotic layer and a grape suspended in a surgical glove filled with sugar water as the amniotic sac, a spinal needle is used to hit the grape under ultrasound guidance, simulating an amniocentesis or cordocentesis procedure. The participants of the study were shown an instructional video of the technique, then filmed performing the procedure. Each attempt was graded according to accuracy in hitting the grape. The process was repeated at a later date and assessed for improvement in proficiency to determine the effectiveness of the simulator.
Results: After obtaining the two trials for all of the subjects, three evaluators will watch the videos and give a score. We will not only compare individuals, but assess for improvement between the first and second trial. Analysis is currently in process.
Discussions: As the use of non-invasive methods of screening for fetal abnormalities become more widespread, the number of amniocentesis and cordocentesis procedures performed will continue to decrease. As volume decreases, the opportunities for performing these high risk procedures enough times in training to gain proficiency and comfortability also decreases. Low cost simulators act as a bridge in learning.
Topics: CREOG & APGO Annual Meeting, 2022, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, Simulation, Maternal-Fetal Medicine, General Ob-Gyn, CREOG & APGO Annual Meeting, 2022, Student, Resident, Clerkship Director, Clerkship Coordinator, Medical Knowledge, UME, Independent Study, Problem-Based Learning,
Kaitlin Hufstetler, MD, WellStar Kennestone GME; James Smeltzer, MD; Lindsey Threlkeld, MD
