Systematic introduction of obstetric ultrasound skills into practice

Abstract

OBJECTIVE: To identify the present skill level of obstetric ultrasound, to set quality standards and to make recommendations in terms of obstetrics ultrasound service improvement. METHODS: An audit was carried out in five provinces in Sri Lanka. At the beginning of the ultrasound workshops, attendees were requested to participate in this audit. Optimum ultrasound machine settings and biometry standards were defined at the beginning. Measures were taken to recruit a cross section of the obstetric service providers including postgraduate trainees and senior house officers (SHOO). They were asked to perform an ultrasound scan and obtain standard images. These images were assessed onsite and documented in structured data sheet. The level of competency was analyzed according to the pre-defined standards. A structured ultrasound training programs have been carried out to improve the existing knowledge and skills of the participants. In order to simulate their own scan environment and habits, participants were assessed without their knowledge in the second phase of this audit. RESULTS: Overall skills in controlling machine settings were very poor. Almost all the participants did not manage to set the machine competently. Postgraduates were slightly better in obtaining correct landmarks for fetal biometry. It is encouraging to note that most of the postgraduates were able to improve their machine setting skills in subsequent audit. First trimester crown-rump length is the least improved fetal biometry in second phase. CONCLUSION: At present background skills of obstetric ultrasound are substandard and it can be improved by dedicated training. Systematic introduction of obstetric ultrasound training in to post graduate training is necessary. This will produce a new generation of obstetricians competent in this field. All the newly appointed SHOO/MOO in obstetrics need to undergo mandatory training in obstetric ultrasound.