Abstract
ObjectiveWidely accepted, validated and objective measures of ultrasound competency have not been established for clinical practice. Outcomes of training curricula are often based on arbitrary thresholds, such as the number of clinical cases completed. We aimed to define metrics against which competency could be measured.MethodWe undertook a prospective, observational study of obstetric sonographers at a UK University Teaching Hospital. Participants were either experienced in fetal ultrasound (n = 10, >200 ultrasound examinations) or novice operators (n = 10, <25 ultrasound examinations). We recorded probe motion data during the performance of biometry on a commercially available mid‐trimester phantom.ResultsWe report that Dimensionless squared jerk, an assessment of deliberate hand movements, independent of movement duration, extent, spurious peaks and dimension differed significantly different between groups, 19.26 (SD 3.02) for experienced and 22.08 (SD 1.05, p = 0.01) for novice operators, respectively. Experienced operator performance, was associated with a shorter time to task completion of 176.46 s (SD 47.31) compared to 666.94 s (SD 490.36, p = 0.0004) for novice operators. Probe travel was also shorter for experienced operators 521.23 mm (SD 27.41) versus 2234.82 mm (SD 188.50, p = 0.007) when compared to novice operators.ConclusionOur results represent progress toward an objective assessment of technical skill in obstetric ultrasound. Repeating this methodology in a clinical environment may develop insight into the generalisability of these findings into ultrasound education.
Highlights
Ultrasound is a dynamic, real-time imaging modality that is widely used in clinical obstetrics for screening of congenital anomalies, to monitor fetal growth and to assess fetal well-being
(n = 10,
When evaluating the images used to estimate fetal weight in accordance with the scoring system detailed in the methodology, we found that experienced operators achieved a higher quality image score than novice operators (10.2 SD 1.46, p = 0.04) (Table 1)
Summary
Ultrasound is a dynamic, real-time imaging modality that is widely used in clinical obstetrics for screening of congenital anomalies, to monitor fetal growth and to assess fetal well-being. Training and competence assessment are of great importance to ensure effective, reproducible and safe clinical practice. Varying standards for training and Prenatal Diagnosis. Assessment of skills have been suggested by bodies such as the American Institute of Ultrasound in Medicine (AIUM)[2] and The International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG).[3] National colleges have introduced varying requirements. The French National College of Gynaecologists and Obstetricians (CNGOF) require practitioners to pass a national examination to obtain certification. Similar challenges for trainees have been reported in other medical[5] and surgical[6] specialities, where reduced training hours have led to concerns[7] that current specialists-in-training will have had fewer training hours than their predecessors.[8]
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