Advertisement

Proceedings: Beyond Ultrasound First Forum on improving the quality of ultrasound imaging in obstetrics and gynecology

      The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The forum brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; in addition to government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound. This group worked together in focus sessions aimed at developing solutions on how to standardize and improve ultrasound training at the resident level and beyond. A new curriculum and competency assessment program for teaching residents (obstetrics and gynecology, radiology, and any other specialty doing obstetrics and gynecology ultrasound) was presented, and performance measures of ultrasound quality in clinical practice were discussed. The aim of this forum was to increase and unify the quality of ultrasound examinations in obstetrics and gynecology with the ultimate goal of improving patient safety and quality of clinical care. This report describes the proceedings of this conference including possible approaches to resident teaching and means to improve the inconsistent quality of ultrasound examinations performed today.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Cuckle H.
        • Platt L.D.
        • Thornburg L.L.
        • et al.
        • Nuchal Translucency Quality Review Program of the Perinatal Quality Foundation
        Nuchal Translucency Quality Review (NTQR) program: first one and half million results.
        Ultrasound Obstet Gynecol. 2015; 45: 199-204
        • D'Alton M.E.
        • Cleary-Goldman J.
        • Lambert-Messerlian G.
        • et al.
        Maintaining quality assurance for sonographic nuchal translucency measurement: lessons from the FASTER trial.
        Ultrasound Obstet Gynecol. 2009; 33: 142-146
        • Chalouhi G.E.
        • Bernardi V.
        • Gueneuc A.
        • Houssin I.
        • Stirnemann J.J.
        • Ville Y.
        Evaluation of trainees' ability to perform obstetrical ultrasound using simulation: challenges and opportunities.
        Am J Obstet Gynecol. 2016; 214: 525.e1-525.e8
        • Madsen M.E.
        • Konge L.
        • Nørgaard L.N.
        • et al.
        Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination.
        Ultrasound Obstet Gynecol. 2014; 44: 693-699
        • Green J.
        • Kahan M.
        • Wong S.
        Obstetric and gynecologic resident ultrasound education project: is the current level of gynecologic ultrasound training in Canada meeting the needs of residents and faculty?.
        J Ultrasound Med. 2015; 34: 1583-1589
        • Lee W.
        • Hodges A.N.
        • Williams S.
        • Vettraino I.M.
        • McNie B.
        Fetal ultrasound training for obstetrics and gynecology residents.
        Obstet Gynecol. 2004; 103: 333-338
        • Abuhamad A.Z.
        • Benacerraf B.R.
        • Woletz P.
        • Burke B.L.
        The accreditation of ultrasound practices: impact on compliance with minimum performance guidelines.
        J Ultrasound Med. 2004; 23: 1023-1029
        • Goldberg J.D.
        Routine screening for fetal anomalies: expectations.
        Obstet Gynecol Clin North Am. 2004; 31: 35-50
        • Karim J.N.
        • Roberts N.W.
        • Salomon L.J.
        • Papageorghiou A.T.
        Systematic review of first trimester ultrasound screening in detecting fetal structural anomalies and factors affecting screening performance.
        Ultrasound Obstet Gynecol. 2016 Aug 22; ([Epub ahead of print])https://doi.org/10.1002/uog.17246
        • Bahtiyar M.O.
        • Copel J.A.
        Improving detection of fetal cardiac anomalies: a fetal echocardiogram for every fetus?.
        J Ultrasound Med. 2007; 26: 1639-1641
        • Hall R.
        • Ogburn T.
        • Rogers R.G.
        Teaching and evaluating ultrasound skill attainment: competency-based resident ultrasound training for AIUM accreditation.
        Obstet Gynecol Clin North Am. 2006; 33: 305-323
        • Asplin N.
        • Dellgren A.
        • Conner P.
        Education in obstetrical ultrasound–an important factor for increasing the prenatal detection of congenital heart disease.
        Acta Obstet Gynecol Scand. 2013; 92: 804-808
        • Salomon L.J.
        • Winer N.
        • Bernard J.P.
        • Ville Y.
        A score-based method for quality control of fetal images at routine second-trimester ultrasound examination.
        Prenat Diagn. 2008; 28: 822-827
        • Mrazek-Pugh B.
        • Blumenfeld Y.J.
        • Lee H.C.
        • Chueh J.
        Obstetric ultrasound quality improvement initiative–utilization of a quality assurance process and standardized checklists.
        Am J Perinatol. 2015; 32: 599-604
        • van Velzen C.L.
        • Clur S.A.
        • Rijlaarsdam M.E.
        • et al.
        Prenatal detection of congenital heart disease–results of a national screening program.
        BJOG. 2016; 123: 400-407
        • D'Alton M.E.
        • Fuchs K.M.
        • Abuhammad A.
        • et al.
        • Nuchal Translucency Quality Review Program
        Implementation of a national nuchal translucency education and quality monitoring program.
        Obstet Gynecol. 2014; 123: 149-154
        • Sayasneh A.
        • Kaijser J.
        • Preisler J.
        • et al.
        Accuracy of ultrasonography performed by examiners with varied training and experience in predicting specific pathology of adnexal masses.
        Ultrasound Obstet Gynecol. 2015; 45: 605-612
        • Benacerraf B.R.
        Ultrasonic diagnosis of ovarian masses: can the playing field be leveled and raised at the same time?.
        Am J Obstet Gynecol. 2016; 214: 419-421
      1. Accreditation Council for Graduate Medical Education. ACGME outcome project. Available at: http://www.acgme.org/outcome. Accessed June 24, 2003.

        • Kasales C.J.
        • Coulson C.C.
        • Mauger D.
        • Chertoff J.D.
        • Matthews A.
        Training in obstetric sonography for radiology residents and fellows in the United States.
        AJR Am J Roentgenol. 2001; 177: 763-767
        • Houston L.E.
        • Allsworth J.
        • Macones G.A.
        Ultrasound is safe… right? Resident and maternal-fetal medicine fellow knowledge regarding obstetric ultrasound safety.
        J Ultrasound Med. 2011; 30: 21-27
        • Hertzberg B.S.
        • Kliewer M.A.
        • Bowie J.D.
        • et al.
        Physician training requirements in sonography: how many cases are needed for competence?.
        AJR Am J Roentgenol. 2000; 174: 1221-1227
        • Salvesen K.A.
        • Lees C.
        • Tutschek B.
        Basic European ultrasound training in obstetrics and gynecology: where are we and where do we go from here?.
        Ultrasound Obstet Gynecol. 2010; 36: 525-529
      2. American Institute of Ultrasound in Medicine. Standards and guidelines for the accreditation of ultrasound practices [official statement]. Available at: http://www.aium.org/officialStatements/26. Accessed July 11, 2017.

      3. Obstetrics And Gynecology Case Logs National Data Report. Available at: http://www.acgme.org/Portals/0/PDFs/220_National_Report_Program_Version_2015-2016.pdf. Accessed July 11, 2017.

        • Berrington de González A.
        • Mahesh M.
        • Kim K.P.
        • et al.
        Projected cancer risks from computed tomographic scans performed in the United States in 2007.
        Arch Intern Med. 2009; 169: 2071-2077
        • Potter A.W.
        • Chandrasekhar C.A.
        US and CT evaluation of acute pelvic pain of gynecologic origin in nonpregnant premenopausal patients.
        Radiographics. 2008; 28: 1645-1659
        • Asch E.
        • Shah S.
        • Kang T.
        • Levine D.
        Use of pelvic computed tomography and sonography in women of reproductive age in the emergency department.
        J Ultrasound Med. 2013; 32: 1181-1187
        • Benacerraf B.R.
        • Abuhamad A.Z.
        • Bromley B.
        • et al.
        Consider ultrasound first for imaging the female pelvis.
        Am J Obstet Gynecol. 2015; 212: 450-455
        • Gigot J.
        • Etienne J.
        • Aerts R.
        • et al.
        The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients.
        Surg Endosc. 1997; 11: 1171-1178
        • Soper N.J.
        Laparoscopic cholecystectomy.
        Curr Probl Surg. 1991; 28: 581-655
        • Tolsgaard M.G.
        • Ringsted C.
        • Dreisler E.
        • et al.
        Sustained effect of simulation-based ultrasound training on clinical performance: a randomized trial.
        Ultrasound Obstet Gynecol. 2015; 46: 312-318
        • ISUOG Education Committee
        Recommendations for basic training in obstetric and gynecological ultrasound.
        Ultrasound Obstet Gynecol. 2014; 43: 113-116
        • Salomon L.J.
        • Winer N.
        • Bernard J.P.
        • Ville Y.
        A score-based method for quality control of fetal images at routine second-trimester ultrasound examination.
        Prenat Diagn. 2008; 28: 822-827
        • Miller G.T.
        • Scerbo M.W.
        • Zybak S.
        • et al.
        Learner improvement from a simulation-enhanced ultrasonography curriculum for first-year medical students.
        J Ultrasound Med. 2017; 36: 609-619
        • Maloney L.
        • Zach K.
        • Page C.
        • Tewari N.
        • Tito M.
        • Seidman P.
        Integration of a low-cost introductory ultrasound curriculum into existing procedural skills education for preclinical medical students.
        J Ultrasound Med. 2017; 36: 367-373