Capacity building in obstetric ultrasound: Impact of simulation based clinical teaching on resident training at a health facility in India

Latika Chawla; Rajan Kumar; Shalini Rajaram; Shalinee Rao; Kanak Dubey; Anupama Bahadur; Amrita Gaurav; Kavita Khoiwal; Rajlaxmi Mundra; Om Kumari; Poonam Gill; Jaya Chaturvedi

doi:10.1002/ijgo.16076

Capacity building in obstetric ultrasound: Impact of simulation based clinical teaching on resident training at a health facility in India

Int J Gynaecol Obstet. 2024 Dec 4. doi: 10.1002/ijgo.16076. Online ahead of print.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
² Department of Continuous Professional Development, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.

PMID: 39629959
DOI: 10.1002/ijgo.16076

Abstract

Objective: Current postgraduate curriculum in India lacks practical training in ultrasound for residents in obstetrics and gynecology. The objective of this study was to develop and assess impact of a capacity building program utilizing clinical teaching and simulation to enhance knowledge and skills of residents at a healthcare facility in India.

Methods: A training program comprising of 14 modules on basic obstetric ultrasounds was created over 3 months. These modules, validated by fetal medicine experts, underwent a pilot study for face validity. A total of 18 newly enrolled junior residents without prior ultrasound experience were recruited. A two-day workshop included interactive module sessions and 6 h and 30 min of hands-on training using an obstetric simulator. Pre- and post-tests consisting of 50 multiple-choice questions (MCQs) assessed knowledge. Follow-up assessments were carried out at 1 and 3 months. Skill assessment at the third month was conducted using an objective structured practical examination (OSPE), alongside image submission by residents.

Results: There was significant improvement in marks over time, with a mean pretest score of 24 ± 2.7 out of 50 marks, post-test score of 36.81 ± 2.86 and stable scores (34.6 ± 3.21, 34.4 ± 2.96) during follow-up reviews. OSPE scores at third month averaged at 21.47 ± 2.3 (maximum marks 30); image assessment scores averaged at 83 ± 8.62 (maximum marks 100). Participant feedback indicated a positive response to all program aspects (practicality, content and structured training). Confidence levels in performing clinical ultrasound improved significantly after attending the module (P < 0.0001).

Conclusion: Simulation with clinical teaching effectively enhanced knowledge and skills of residents, fostering confidence in performing basic obstetric ultrasounds early on in their residency. Integrating similar capacity building initiatives into residency training programs can improve healthcare delivery by ensuring a well prepared cadre of doctors skilled in obstetric ultrasounds.

Keywords: India; capacity building; clinical teaching; obstetric; resident; simulation; training; ultrasound.