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420: Impact of an amniocentesis simulation curriculum for training in MFM fellowship program

2013; Elsevier BV; Volume: 210; Issue: 1 Linguagem: Inglês

10.1016/j.ajog.2013.10.453

1097-6868

Nauman Khurshid, Barbara Trampe, Timothy Heiser, Laura E. Birkeland, Elizabeth Duris, Katharina Stewart, Dinesh Shah, Jesus Igor Iruretagoyena,

Congenital Anomalies and Fetal Surgery

ObjectiveTo evaluate the impact of introducing an amniocentesis simulation curriculum in the MFM fellowship training.Study DesignA new curriculum to teach amniocentesis was created in 2009 comprising of reading assignments, group discussion, and hands on simulation. This ecoflex silicon model resembles the maternal interface when interrogated by ultrasound waves. Versatility of the simulation model allows recreating real life situations by changing fetal positions and placental locations. During the simulation sessions the fellows learn both one hand (guided by sonographer) and two hands techniques (guiding themselves). Communication skills are also stressed upon. Real life amniocentesis are performed by the fellow once adequate skills are achieved. The course is completed in the first 6 months of fellowship. Amniocentesis performance of the fellows that received simulation training was compared with the fellows who did not receive the training. To evaluate objective differences, assessment included number of attempts per amniocentesis, bloody aspirate, transplacental needle entry, fetal injury, abruption and preterm premature rupture of membranes.Results256 amniocentesis were performed by fellows. The simulation curriculum decreased the number of attempts by first and second year fellows to complete a procedure. In the pre-simulation training group (Figure 1), there were 12 events in which more than one attempt was made to complete the amniocentesis during the first year of training, 7 in second year and none in their third year. The post simulation training group had no second attempts in any training year. There were no differences in complications. Figure 2 shows decrease in amniocentesis procedures over the past 6 years. The numbers of amniocentesis performed by the fellows have remained stable.ConclusionView Large Image Figure ViewerDownload Hi-res image Download (PPT) ObjectiveTo evaluate the impact of introducing an amniocentesis simulation curriculum in the MFM fellowship training. To evaluate the impact of introducing an amniocentesis simulation curriculum in the MFM fellowship training. Study DesignA new curriculum to teach amniocentesis was created in 2009 comprising of reading assignments, group discussion, and hands on simulation. This ecoflex silicon model resembles the maternal interface when interrogated by ultrasound waves. Versatility of the simulation model allows recreating real life situations by changing fetal positions and placental locations. During the simulation sessions the fellows learn both one hand (guided by sonographer) and two hands techniques (guiding themselves). Communication skills are also stressed upon. Real life amniocentesis are performed by the fellow once adequate skills are achieved. The course is completed in the first 6 months of fellowship. Amniocentesis performance of the fellows that received simulation training was compared with the fellows who did not receive the training. To evaluate objective differences, assessment included number of attempts per amniocentesis, bloody aspirate, transplacental needle entry, fetal injury, abruption and preterm premature rupture of membranes. A new curriculum to teach amniocentesis was created in 2009 comprising of reading assignments, group discussion, and hands on simulation. This ecoflex silicon model resembles the maternal interface when interrogated by ultrasound waves. Versatility of the simulation model allows recreating real life situations by changing fetal positions and placental locations. During the simulation sessions the fellows learn both one hand (guided by sonographer) and two hands techniques (guiding themselves). Communication skills are also stressed upon. Real life amniocentesis are performed by the fellow once adequate skills are achieved. The course is completed in the first 6 months of fellowship. Amniocentesis performance of the fellows that received simulation training was compared with the fellows who did not receive the training. To evaluate objective differences, assessment included number of attempts per amniocentesis, bloody aspirate, transplacental needle entry, fetal injury, abruption and preterm premature rupture of membranes. Results256 amniocentesis were performed by fellows. The simulation curriculum decreased the number of attempts by first and second year fellows to complete a procedure. In the pre-simulation training group (Figure 1), there were 12 events in which more than one attempt was made to complete the amniocentesis during the first year of training, 7 in second year and none in their third year. The post simulation training group had no second attempts in any training year. There were no differences in complications. Figure 2 shows decrease in amniocentesis procedures over the past 6 years. The numbers of amniocentesis performed by the fellows have remained stable. 256 amniocentesis were performed by fellows. The simulation curriculum decreased the number of attempts by first and second year fellows to complete a procedure. In the pre-simulation training group (Figure 1), there were 12 events in which more than one attempt was made to complete the amniocentesis during the first year of training, 7 in second year and none in their third year. The post simulation training group had no second attempts in any training year. There were no differences in complications. Figure 2 shows decrease in amniocentesis procedures over the past 6 years. The numbers of amniocentesis performed by the fellows have remained stable. Conclusion