VP34.19: Attainment rates of trainee competence in different biometric parameters during a practical ultrasound training course: is there a difference?

To assess the comparative difficulty in acquiring the different proficiencies in biometry following basic fetal ultrasound training workshop. A pre- and post-course comparison study to assess the difference in competence of ultrasound naive trainees in quantitative form, following an ISUOG-accredited 5-day hands-on, basic ultrasound workshop. Participants had an average of 8 hours per day training for 5 days involving approximately 50% theory and 50% practical sessions. Parameters tested include biparietal diameter, head circumference, abdominal circumference and femur length. Domains assessed were image recognition, accuracy of plane, optimisation of views and accurate placement of calipers. The composite score for each competence ranged from 4 to 16. Designated facilitators performed real time assessment of the images produced for each biometric parameter. Total from all steps n (%) Step 1: Presentation Confirmed Unconfirmed No video 46 (58%) 31 (39%) 3 (4%) 32 (40%) n/a n/a 1 (1%) n/a n/a 1 (1%) n/a n/a n/a n/a n/a 80 (100%) 0 n/a Step 2: FH visualised Confirmed Unconfirmed No video n/a n/a n/a 62 (78%) 15 (19%) 3 (4%) 13 (16%) n/a n/a 3 (4%) n/a n/a 1 (1%) n/a n/a 79 (99%) 1 (1%) n/a Step 3: Number fetuses Confirmed Unconfirmed No video n/a n/a n/a n/a n/a n/a 80 (100%) 0 0 n/a n/a n/a n/a n/a n/a 80 (100%) 0 n/a Step 4: Placental location Confirmed Unconfirmed No video n/a n/a n/a n/a n/a n/a 8 (10%) n/a n/a 61 (76%) 18 (23%) 1 (1%) n/a n/a n/a 69 (86%) 11 (14%) n/a Step 5: Amniotic fluid assessment Confirmed Unconfirmed No video n/a n/a n/a n/a n/a n/a 1 (1%) n/a n/a n/a n/a n/a 79 (99%) 0 1 (1%) 80 (100%) 0 n/a A total number of 23 out of the 57 participants at the workshop were randomly selected for assessment, including 10 Medical officers, 10 Obstetricians and 3 resident doctors. None of the participants reported a previous ultrasound training experience. The median (IQ25,IQ75) pre- and post- training composite competence score for BPD; HC; AC and FL; were 6(5,7) and 12(10,14); 5(4,7) and 13(10,13); 6(4,8) and 11(10,13); 5(4,7) and 10(5,14); respectively. The differences for all the biometric indices were statistically significant, in favour of the post-training scores (t <0.001). The improvements in competence were in the order of HC, BPD, AC, with FL showing the least competence. The FL also showed the widest variability of competence scores after training. There is statistically significant improvement in fetal biometry competence scores of ultrasound naïve trainees following a 5-day obstetric training workshop. The femur length appears to be the most difficult to learn. Trainers are therefore advised to allot additional time to accommodate this during training.