Formal Training Improves Obstetricians' Ultrasound Skills

March 01, 1997

Young physicians who undergo a rigorous formal training program in ultrasound testing on pregnant women are better skilled at this procedure than young physicians without such training, a Johns Hopkins study suggests.

Results show that Hopkins second- and third-year obstetrics residents who underwent a formal training program in obstetrical ultrasound had a mean score of 67 percent on a practical exam compared with 53 percent by obstetrics residents at a similar institution that does not have such a program.

Currently, there are no formal guidelines for training residents in obstetrical ultrasound, although 70 percent of women undergo ultrasound evaluation during pregnancy. Many sonograms are performed on an informal basis in their obstetrician's office or by an obstetrician in a labor and delivery unit.

"Our findings show that a formal method for assessing residents' progress and documenting their competence in obstetrical ultrasound is both feasible and effective," says Jessica L. Bienstock, M.D., lead author and an instructor in gynecology/obstetrics.

Results will be presented Feb. 28 at the annual meeting of the Association of Professors in Obstetrics and Gynecology and Council on Resident Education in Obstetrics and Gynecology in New Orleans.

"Our goal was to develop a tool that could be used by residents to evaluate their progress in ultrasound throughout their four years of training and ensure that they acquire the skills required to perform complete obstetrical ultrasounds," says Bienstock.

The formal program includes a check-list that identifies sonographic skills considered appropriate for each year of residency, such as basic concepts, completing screens on their own, diagnosing problems, reviewing hundreds of cases, and completing paperwork. The residents must demonstrate each skill to a senior ultrasound technician or a perinatologist (a physician specializing in fetal medicine) certified in obstetrical ultrasound.

Fetal ultrasound scanning, or sonography, involves passing high frequency sound waves into the mother's body; the reflected echoes are detected and analyzed to build a two-dimensional picture of the fetus in the uterus.

The study's senior author was Eva K. Pressman, M.D.


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