An ultrasound-based simulation to improve clinical competency in evaluation of first-trimester bleeding in undergraduate medical education.

Abstract

Objectives: To implement a transvaginal ultrasound (TVUS) simulation to improve comfort with obstetric and gynaecologic ultrasound and increase knowledge in diagnosis and management of early pregnancy-related complications.

Methods: Third-year medical students enrolled in the Obstetrics and Gynaecology (OBGYN) clerkship between 2023 and 2024 participated in a didactic session and ultrasound simulation about aetiologies for vaginal bleeding in early pregnancy. They were guided through four different clinical scenarios of pelvic pathology including a non-pregnant uterine model representing a pregnancy of unknown location (PUL), ectopic pregnancy and normal first-trimester intrauterine pregnancy. Pre- and post-assessments were completed focused on knowledge and self-perceived confidence in evaluation and management of early pregnancy bleeding using TVUS.

Results: A total of 109 students completed the pre-assessment, and 104 completed the post-assessment. The mean pre-simulation knowledge score was 58%, and mean post-test knowledge score was 69%. We compared pre- and post-simulation percent correct which showed approximately a 11% increase in percent correct in the assessment after the didactic and ultrasound simulation (p-value < 0.05). Overall comfort in diagnosis of early pregnancy complications and TVUS skills significantly increased from an average Likert-type scale of 2 to 5 (p < 0.05).

Conclusion: TVUS simulation can be a helpful adjunct to learning important women's health topics and should be considered an important skill in training future physicians.