Improving the quality of transvaginal ultrasound scan by simulation training for general practice residents

M Le Lous,N De Chanaud,A Tesnière,A Tesnière,A Tesnière,A Tesnière,V Tsatsaris,V Tsatsaris,V Tsatsaris,P Jaury,P Jaury,A Bourret,A Bourret,A Bourret,C Colmant,C Colmant,C Colmant,C Colmant,M V Senat

doi:10.1186/s41077-017-0056-z

Abstract

BackgroundUltrasonography (US) is an essential tool for the diagnosis of acute gynecological conditions. General practice (GP) residents are involved in the first-line management of gynecologic emergencies. They are not familiar with US equipment. Initial training on simulators was conducted.The aim of this study was to evaluate the impact of simulation-based training on the quality of the sonographic images achieved by GP residents 2 months after the simulation training versus clinical training alone.MethodsYoung GP residents assigned to emergency gynecology departments were invited to a one-day simulation-based US training session. A prospective controlled trial aiming to assess the impact of such training on TVS (transvaginal ultrasound scan) image quality was conducted. The first group included GP residents who attended the simulation training course. The second group included GP residents who did not attend the course. Written consent to participate was obtained from all participants. Images achieved 2 months after the training were scored using standardized quality criteria and compared in both groups. The stress generated by this examination was also assessed with a simple numeric scale.ResultsA total of 137 residents attended the simulation training, 26 consented to participate in the controlled trial. Sonographic image quality was significantly better in the simulation group for the sagittal view of the uterus (3.6 vs 2.7, p = 0.01), for the longitudinal view of the right ovary (2.8 vs 1.4, p = 0.027), and for the Morrison space (1.7 vs 0.4, p = 0.034), but the difference was not significant for the left ovary (2.9 vs 1.7, p = 0.189). The stress generated by TVS after 2 months was not different between the groups (6.0 vs 4.8, p = 0.4).ConclusionSimulation-based training improved the quality of pelvic US images in GP residents assessed after 2 months of experience in gynecology compared to clinical training alone.

Highlights

Ultrasonography (US) is an essential tool for the diagnosis of acute gynecological conditions
A total of 137 General practice (GP) residents participated in the training
36 GP residents provided consent to participate in the controlled trial, 26 in the simulation group and 10 in the control group (Fig. 2)

Summary

Introduction

Ultrasonography (US) is an essential tool for the diagnosis of acute gynecological conditions. General practice (GP) residents are involved in the first-line management of gynecologic emergencies. They are not familiar with US equipment. Ultrasound has become an indispensable tool for the identification of most gynecologic emergencies [1] In France, during their residency, more than 50% of general practice (GP) residents are assigned to gynecology units for 6 months They are involved in the first-line management of gynecologic. GP residents practice TVS by a combination of observing senior gynecologists and practicing themselves under the supervision of seniors [5] Because it is invasive, TVS may create patient discomfort, especially if performed by a novice or, even more, by several operators

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