Qualitätsgesichertes Ultraschall-Simulator-Training zur Erkennung fetaler Fehlbildungen - Lässt sich ein Lernerfolg durch das Training am Ultraschall-Simulator belegen?

Abstract

The factual sonographic training in obstetrics differs in Germany in a broad range. In this context, a tendency towards minimalistic dealings with this issue prevails. In contrast to this, the provisions of the German maternity guidelines relating to ultrasound clearly define quality oriented requirements serving altogether as a basic sonographic standard which mandatorily has to be met by all German Obstetricians. In order to close this gap between professional education and social demand, a training concept regarding obstetric ultrasound was devised by the German Association of Gynecologists utilizing the ultrasound simulator system. The aim of this study was to evaluate the usefulness and the effectiveness of this method and its potential role and benefit in structured sonographic training. Between October 2004 and August 2005, 74 obstetric ultrasound training courses according to the ultrasound simulator concept of the Medical School of Hanover were realized in nine federal states of Germany by the German Academy of Gynecology. The aim of these courses was it to procure ultrasound knowledge regarding the structured sonographic exclusion of fetal malformations in a compact manner. As a measure of quality assurance, a standardized questionnaire was issued before and after the courses in order to analyze the benefit of these simulator-based ultrasound courses. The concept found prevailing approval (90 %) at the level of principle, practical implementation and clinical usefulness. 88,2 % of the participants estimated their subjective training effect as being good. The analysis of the questionnaire showed a statistically significant improvement of sonographic knowledge. On average, 74.1 % of the questions were answered correctly by the end of the course as opposed to a mere 46.3 % at the beginning. Structured ultrasound training courses based on the ultrasound simulator system seem to be able to define a basic quality of training and significantly improves examiners' skills in prenatal medicine possible independent of local or structural factors. Hence they seem to be a suitable instrument to close the gap between the sonographic education worthy of improvement and the existing social demand for efficiacy of obstetric sonography.