Improving Detection of Fetuses at Risk - Who Needs Systematic Training?

Study Overview
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Brief Summary
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Detection of growth restricted fetuses relies primarily on abdominal ultrasound examinations during pregnancy. Many clinicians, however, have not received systematic training and may therefore perform inadequately. We wish to examine, whether systematic, simulation-based training can improve diagnostic accuracy of estimated fetal weight by ultrasound at different levels of clinical experience.

Detailed Description
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Participants are physicians working at obstetric departments. Participant characteristics (age, experience in years and number of monthly scans) are recorded. Participants perform two abdominal growth scans prior to randomization and estimated fetal weight is compared to birth weight. Mean absolute percentage error is calculated as a measure of diagnostic accuracy. Participants are then randomized to either control (no intervention) or intervention. The latter group receives training on the Metaphor Scantrainer trans abdominal ultrasound simulator until they pass a previously validated test. After completing the training the participants use a mannikin to practice systematic approach and 'knobology'. All participants then perform another two growth scans. Diagnostic accuracy before and after the intervention or control period is compared. We wish to examine the effect of systematic training on the diagnostic accuracy of estimated fetal weight by ultrasound across different levels of clinical experience. If an effect can be found in the inexperienced participants, simulation-based training in obstetric ultrasound could be implemented as a part of basic obstetric training and/or as a means of maintaining skills.

Official Title
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Improving Detection of Fetuses at Risk - Who Needs Systematic Training?

Conditions
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Improving Obstetric Ultrasound Skills

Intervention / Treatment
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* Other: simulation-based training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: proficiency in the Danish language no prior experience with obstetric ultrasound simulation doctors who work within the field of gynecology and obstetrics Exclusion Criteria: lack of proficiency in the Danish language prior experience with obstetric ultrasound simulation
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Simulation-based training: Virtual-reality simulation training on the Medaphor Scantrainer Transabdominal Simulator until expert level is reached. Then training on a physical mannikin until an average OSAUS-score of 3 or more is attained. | Other: simulation-based training<br>* As described under group descriptions<br>|
| No Intervention: Control<br>No intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic accuracy of estimated fetal weight by ultrasound. | percentage error of fell weight estimate compared to actual fetal weight | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ratings of ultrasound images | Images are rated using the image-scoring method by Salomon et al. (Salomon et al. Feasibility and reproducibility of an image-scoring method for quality control of fetal biometry in the second trimester. Ultrasound Obstet Gynecol 2006;27;34-40) The images are scores on the number of landmarks, correct caliper placement and image optimization. A minimum of 0 and a maximum of 16 points can be given (best possible score). | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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simulation-based training, obstetric ultrasound, intrauterine growth restriction, ultrasound simulation