Implementing Methodology for Teaching Initial Radiology for First Year Radiology Residents in on Obstetrical Ultrasound

Abstract

Introduction of a new teaching methodology in obstetrical ultrasound especially aimed at beginners, to enable initial radiology residents toperform a complete Doppler Ultrasound after one month of internship. Obstetrical ultrasound learning occurs in the first and second years of residence in Radiology. First year residents usually have little or no experience in ultrasound before their obstetrical stage. During the first year, the purpose of internship is to perform a complete obstetrical ultrasound exam with dopplerfluxometry. In view of the inexperience of these residents, we created a teaching methodology in 2014; therefore, three full years of use have been completes. The teaching sequence was: Step 1: Only biometry was introduced, following recommended international guidelines: head circumference, bi parietal diameter, occipital frontal diameter; abdominal circumference, femur length, humerus length. Step 2: After a satisfactory performance in biometry resident are introduced to the techniques of checking the spine, diaphragm, four heart chambers and placenta, both for measurement and grading. Step3: After residents perform adequately for steps one and two, the move to step three, which consists in the performance of dopplerfluxometry for determination of heart beating, umbilical artery, median cerebral artery and uterine artery. Step 4: After a satisfactory step three, residents move to estimation of amniotic fluid index, cervix length, nuchal fold, lateral atrium cerebral, pelvis renal diameter and details of fetal face. Percentile 10 : no capacity to perform complete steps one and two Percentile 25: capacity to perform steps one and two but incomplete step three. Percentile 50: Capacity to perform steps one, two and three and part of step four. Percentile 75: Capacity to perform all steps. In 2014, 19 first year residents were subjected to the method, in 2015 26 first year residents, in 2016 28 residents, with percentile distribution as shown in table 1.Table 1: Relationship between number of students by year correlated with percentiles PercentilesYears 10255075201412 13320153 41722016 2619 2” The new method proved to be effective as a first approach for teaching initiating residents. As a result, about 80% of new residents could perform a complete obstetrical dopplerfluxometry ultrasound test. After a complete year of residence, we checked the opinion of the students and found that 80% of them declared themselves capable of realizing an obstetrical examination with dopplerfluxometry ultrasound examination. This agreed with our evaluation about their performance.