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CC BY-NC-ND 4.0 · Ultraschall Med 2023; 44(04): e199-e205
DOI: 10.1055/a-1984-8320
Original Article

Controlled Prospective Study on the Use of Systematic Simulator-Based Training with a Virtual, Moving Fetus for Learning Second-Trimester Scan: FESIM III

Kontrollierte, prospektive Studie zur Erlernbarkeit von erweiterten Zweittrimesterschalls mittels simulationsbasiertem Ultraschalltrainings mit einem virtuellen, sich bewegenden Fetus: FESIM III
Paula Freundt  ‡
1   Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Germany
,
Nasenien Nourkami-Tutdibi  ‡
1   Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Germany
,
Erol Tutdibi
1   Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Germany
,
Paul Janzing 
1   Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Germany
,
Thomas von Ostrowski
2   Prenatal Medicine Dorsten, Dorsten, Germany
,
Martin Langer
3   Practice for Gynecology and Women Health, LARA, Bocholt, Germany
,
Michael Zemlin 
1   Hospital for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Germany
,
Johannes Steinhard 
4   Fetal Cardiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Bad Oeynhausen, Germany
5   Prenatal Medical Center Münster, Münster, Germany
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Abstract

Objectives To analyze the feasibility of structured ultrasound simulation training (SIM-UT) in teaching second-trimester ultrasound screening using a high-end simulator with a randomly moving fetus.

Methods This was a prospective, controlled trial. A trial group of 11 medical students with minimal obstetric ultrasound experience underwent 12 hours of structured SIM-UT in individual hands-on sessions within 6 weeks. Learning progress was assessed with standardized tests. Performance after 2, 4, and 6 weeks of SIM-UT was compared with two reference groups ((A) Ob/Gyn residents and consultants, and (B) highly skilled DEGUM experts). Participants were asked to acquire 23 2nd trimester planes according to ISUOG guidelines in a realistic simulation B-mode with a randomly moving fetus as quickly as possible within a 30-minute time frame. All tests were analyzed regarding the rate of appropriately obtained images and the total time to completion (TTC).

Results During the study, novices were able to improve their ultrasound skills significantly, reaching the physician level of the reference group (A) after 8 hours of training. After 12 hours of SIM-UT, the trial group performed significantly faster than the physician group (TTC: 621±189 vs. 1036±389 sec., p=0.011). Novices obtained 20 out of 23 2nd trimester standard planes without a significant time difference when compared to experts. TTC of the DEGUM reference group remained significantly faster (p<0.001) though.

Conclusion SIM-UT on a simulator with a virtual, randomly moving fetus is highly effective. Novices can obtain standard plane acquisition skills close to expert level within 12 hours of self-training.

Zusammenfassung

Ziel Die Untersuchung des strukturierten, simulationsbasierten Ultraschalltrainings (SIM-UT) an einem High-End-Simulator mit einem sich zufällig bewegenden Fetus für das Erlernen des erweiterten Zweit-Trimester-Screenings.

Methoden In einer prospektiven, kontrollierten Studie trainierten 11 Medizinstudierende mit minimaler gynäkologischer Ultraschallerfahrung über 6 Wochen insgesamt 12h SIM-UT in 12 Einzelsitzungen. Der Lernfortschritt wurde in einem standardisierten Test am Simulator regelmäßig überprüft: 23 Standardebenen eines erweiterten Screening-Protokolls gemäß ISUOG-Standard sollten ohne Hilfestellungen so schnell wie möglich innerhalb von 30 min am Simulator dargestellt werden. Die Ergebnisse wurden anhand desselben standardisierten Tests mit (A) 10 Gynäkolog*innen und (B) 10 DEGUM-Expert*innen als Referenzgruppen verglichen. Alle Tests wurden hinsichtlich der Rate korrekt dargestellter Ebenen und der Gesamtzeit der Untersuchung (TTC) ausgewertet.

Ergebnisse Im Laufe der Studie verbesserte die Interventionsgruppe ihre Leistung signifikant und erreichte nach 8h SIM-UT das Niveau der Referenzgruppe (A). Nach 12h SIM-UT waren die Studierenden signifikant schneller als die Referenzgruppe (A) (TTC: 621±189 vs. 1036±389 Sek., p=0,011). Im Aufsuchen von 20 der 23 Ebenen unterschied sich die Geschwindigkeit der Interventionsgruppe nicht mehr signifikant von der der Expert*innen. Die TTC der DEGUM-Expert*innen blieb jedoch signifikant schneller (p<0,001).

Schlussfolgerungen SIM-UT an einem Simulator mit einem virtuellen, sich zufällig bewegenden Fetus ist hoch effektiv. Ultraschallanfänger*innen erreichen Ärzt*innenstandard innerhalb von 8h eigenständigen Trainings.

Keywords

prenatal detection rate - simulation-based medical education - fetal ultrasound - ultrasound simulation - second-trimester screening


Publication History

Received: 13 October 2022

Accepted after revision: 16 November 2022

Article published online:
07 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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