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March 5, 1997
FORMAL TRAINING IMPROVES OBSTETRICIANS' ULTRASOUND SKILLS
Young physicians who undergo a rigorous formal trainingprogram in ultrasound testing on pregnant women are betterskilled at this procedure than young physicians without suchtraining, a Johns Hopkins study suggests.
Results show that Hopkins second- and third-year obstetricsresidents who underwent a formal training program in obstetricalultrasound had a mean score of 67 percent on a practical examcompared with 53 percent by obstetrics residents at a similarinstitution that does not have such a program.
Currently, there are no formal guidelines for trainingresidents in obstetrical ultrasound, although 70 percent of womenundergo ultrasound evaluation during pregnancy. Many sonogramsare performed on an informal basis in their obstetrician's officeor by an obstetrician in a labor and delivery unit.
"Our findings show that a formal method for assessingresidents' progress and documenting their competence inobstetrical ultrasound is both feasible and effective," saysJessica L. Bienstock, M.D., lead author and an instructor ingynecology/obstetrics.
Results will be presented Feb. 28 at the annual meeting of theAssociation of Professors in Obstetrics and Gynecology andCouncil on Resident Education in Obstetrics and Gynecology in NewOrleans.
"Our goal was to develop a tool that could be used byresidents to evaluate their progress in ultrasound throughouttheir four years of training and ensure that they acquire theskills required to perform complete obstetricalultrasounds," says Bienstock.
The formal program includes a check-list that identifiessonographic skills considered appropriate for each year ofresidency, such as basic concepts, completing screens on theirown, diagnosing problems, reviewing hundreds of cases, andcompleting paperwork. The residents must demonstrate each skillto a senior ultrasound technician or a perinatologist (aphysician specializing in fetal medicine) certified inobstetrical ultrasound.
Fetal ultrasound scanning, or sonography, involves passinghigh frequency sound waves into the mother's body; the reflectedechoes are detected and analyzed to build a two-dimensionalpicture of the fetus in the uterus.
The study's senior author was Eva K. Pressman, M.D.
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