Background
Evaluation of trainee’s ability in obstetrical ultrasound is a time-consuming process,
which requires involving patients as volunteers. With the use of obstetrical ultrasound
simulators, virtual reality could help in assessing competency and evaluating trainees
in this field.
Objective
The objective of the study was to test the validity of an obstetrical ultrasound simulator
as a tool for evaluating trainees following structured training by comparing scores
obtained on obstetrical ultrasound simulator with those obtained on volunteers and
by assessing correlations between scores of images and of dexterity given by 2 blinded
examiners.
Study Design
Trainees, taking the 2013 French national examination for the practice of obstetrical
ultrasound were asked to obtain standardized ultrasound planes both on volunteer pregnant
women and on an obstetrical ultrasound simulator. These planes included measurements
of biparietal diameter, abdominal circumference, and femur length as well as reference
planes for cardiac 4-chamber and outflow tracts, kidneys, stomach/diaphragm, spine,
and face. Images were stored and evaluated subsequently by 2 national examiners who
scored each picture according to previously established quality criteria. Dexterity
was also evaluated and subjectively scored between 0 and 10. The Raghunathan’s modification
of Pearson, Filon’s z, Spearman’s rank correlation, and analysis of variance tests
were used to assess correlations between the scores by the 2 examiners and scores
of dexterity and also to compare the final scores between the 2 different methods.
Results
We evaluated 29 trainees. The mean dexterity scores in simulation (6.5 ± 2.0) and
real examination (5.9 ± 2.3) were comparable (P = .31). Scores with an obstetrical ultrasound simulator were significantly higher
than those obtained on volunteers (P = .027). Nevertheless, there was a good correlation between the scores of the 2 examiners
judging on simulation (R = 0.888) and on volunteers (R = 0.873) (P = .81).
Conclusion
An obstetrical ultrasound simulator is as good a method as volunteer-based examination
for evaluating practical skills in trainees following structured training in obstetrical
ultrasound. The threshold for success/failure should, however, be adapted as candidates
obtain higher scores on the simulator. Advantages of the obstetrical ultrasound simulator
include the absence of location and time constraints without the need to involve volunteers
or to interfere with the running of ultrasound clinics. However, an obstetrical ultrasound
simulator still lacks the ability to evaluate the trainees’ ability to interact with
patients.
Key words
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Article Info
Publication History
Published online: November 04, 2015
Accepted:
October 29,
2015
Received in revised form:
October 6,
2015
Received:
August 4,
2015
Footnotes
The authors report no conflict of interest.
Cite this article as: Chalouhi GE, Bernardi V, Gueneuc A, et al. Evaluation of trainees’ ability to perform obstetrical ultrasound using simulation: challenges and opportunities. Am J Obstet Gynecol 2016;214:525.e1-8.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
