Pioneering point-of-care obstetric ultrasound integration in midwifery education - the MEPOCUS study.


Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
24 Oct 2024
Historique:
received: 09 08 2024
accepted: 18 10 2024
medline: 25 10 2024
pubmed: 25 10 2024
entrez: 25 10 2024
Statut: epublish

Résumé

Ultrasound technology is indispensable in perinatal care due to its non-invasive and painless nature, offering vital insights into foetal development and childbirth. With the academisation of midwifery in Germany, there is a growing necessity to incorporate ultrasound training into midwifery education. This paper discusses the development and implementation of an introductory obstetric ultrasound curriculum tailored for midwifery students, focusing on fundamental ultrasound techniques in obstetrics. We used Kern's six-step approach of curricular development comprising [1] problem identification and general needs assessment [2], needs assessment of the targeted learners [3], goals and objectives [4], educational strategies [5], implementation, and [6] evaluation and feedback. The individual components of the curriculum were meticulously designed based on comprehensive literature reviews, thorough consultations with experienced ultrasound experts and evaluated needs of participants prior to the course instruction. Twenty-seven ultrasound-naive midwifery students participated in the newly developed obstetric ultrasound course. Structured as a modular and integrated framework, the course aimed to provide theoretical and practical instruction in basic obstetric ultrasound, with intrapartum sonography and focused assessment with abdominal sonography for trauma (FAST) as key supplementary specialisations. The results demonstrated a significant increase in the students' overall knowledge and practical skills, as evidenced by the median post-course total score rising from 20 to 60 out of 75 (p < 0.001) in the objective structured clinical examination (OSCE) and from 9 to 19 out of 20 (p = 0.001) in the knowledge test. Additionally, students reported high satisfaction with the course and noted substantial personal benefits. The integration of basic obstetric ultrasound training within the midwifery curriculum is feasible and effective to teach fundamental knowledge and skills of obstetric ultrasound examinations to midwifery students. Expansion, standardisation and regulatory structures are critical components for a continued improvement and realistic integration into midwifery educational frameworks and thus the further development of the midwifery profession.

Sections du résumé

BACKGROUND BACKGROUND
Ultrasound technology is indispensable in perinatal care due to its non-invasive and painless nature, offering vital insights into foetal development and childbirth. With the academisation of midwifery in Germany, there is a growing necessity to incorporate ultrasound training into midwifery education. This paper discusses the development and implementation of an introductory obstetric ultrasound curriculum tailored for midwifery students, focusing on fundamental ultrasound techniques in obstetrics.
MATERIALS AND METHODS METHODS
We used Kern's six-step approach of curricular development comprising [1] problem identification and general needs assessment [2], needs assessment of the targeted learners [3], goals and objectives [4], educational strategies [5], implementation, and [6] evaluation and feedback. The individual components of the curriculum were meticulously designed based on comprehensive literature reviews, thorough consultations with experienced ultrasound experts and evaluated needs of participants prior to the course instruction.
RESULTS RESULTS
Twenty-seven ultrasound-naive midwifery students participated in the newly developed obstetric ultrasound course. Structured as a modular and integrated framework, the course aimed to provide theoretical and practical instruction in basic obstetric ultrasound, with intrapartum sonography and focused assessment with abdominal sonography for trauma (FAST) as key supplementary specialisations. The results demonstrated a significant increase in the students' overall knowledge and practical skills, as evidenced by the median post-course total score rising from 20 to 60 out of 75 (p < 0.001) in the objective structured clinical examination (OSCE) and from 9 to 19 out of 20 (p = 0.001) in the knowledge test. Additionally, students reported high satisfaction with the course and noted substantial personal benefits.
CONCLUSION CONCLUSIONS
The integration of basic obstetric ultrasound training within the midwifery curriculum is feasible and effective to teach fundamental knowledge and skills of obstetric ultrasound examinations to midwifery students. Expansion, standardisation and regulatory structures are critical components for a continued improvement and realistic integration into midwifery educational frameworks and thus the further development of the midwifery profession.

Identifiants

pubmed: 39449045
doi: 10.1186/s12909-024-06221-4
pii: 10.1186/s12909-024-06221-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1209

Informations de copyright

© 2024. The Author(s).

Références

Abramowicz JS. Obstetric ultrasound: where are we and where are we going? Ultrasonography. 2021;40(1):57–74.
doi: 10.14366/usg.20088
Van Adrichem A, Faes E, Kinget K, Jacquemyn Y. Intrapartum ultrasound: viewpoint of midwives and parturient women and reproducibility. Int J Womens Health. 2018;10:251–6.
doi: 10.2147/IJWH.S155865
Herbst MK, Tafti D, Shanahan MM. Obstetric Ultrasound. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Apr 2]. http://www.ncbi.nlm.nih.gov/books/NBK470450/
Dębska M, Kretowicz P, Dębski R. Intrapartum sonography – eccentricity or necessity? J Ultrason. 2015;15(61):125–36.
doi: 10.15557/JoU.2015.0011
Wilkinson M, Usman S, Barton H, Lees CC. The views of pregnant women, midwives, and a women’s panel on intrapartum ultrasound research: a pilot study. Australas J Ultrasound Med. 2019;22(3):186–90.
doi: 10.1002/ajum.12162
Malvasi A, Vimercati A. Is it time for midwives to do intrapartum ultrasound in the delivery ward? J Matern Fetal Neonatal Med. 2022;35(25):9568–9.
doi: 10.1080/14767058.2022.2047927
Casmod Y, Armstrong SJ. Obstetric ultrasound training programmes for midwives: a scoping review. Health SA Gesondheid. 2023;28:2163.
doi: 10.4102/hsag.v28i0.2163
Mubuuke AG, Nassanga R. Point of care obstetric ultrasound knowledge retention among mid-wives following a training program: a prospective cohort pilot study. BMC Pregnancy Childbirth. 2023;23(1):104.
doi: 10.1186/s12884-023-05429-4
Viner AC, Membe-Gadama G, Whyte S, Kayambo D, Masamba M, Makwakwa E, et al. Training in Ultrasound to Determine Gestational Age (TUDA): evaluation of a Novel Education Package to teach Ultrasound-Naive midwives Basic Obstetric Ultrasound in Malawi. Front Glob Womens Health. 2022;3:880615.
doi: 10.3389/fgwh.2022.880615
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience [Internet]. Geneva: World Health Organization. 2016 [cited 2024 Aug 1]. 152 p. https://iris.who.int/handle/10665/250796
Reiso M, Langli B, Sommerseth E, Johannessen A. A qualitative study of the work experiences of midwives performing obstetric ultrasound in Norway. BMC Pregnancy Childbirth. 2020;20:641.
doi: 10.1186/s12884-020-03333-9
Plappert CF, Bauer NH, Dietze-Schwonberg K, Grieshop M, Kluge-Bischoff A, Zyriax BC, et al. Academic education of midwives in Germany (part 1): requirements for bachelor of science programmes in midwifery education. Position paper of the Midwifery Science Committee (AHW) in the DACH Association for Medical Education (GMA). GMS J Med Educ. 2024;41(3):Doc33.
Kern DE. Curriculum Development for Medical Education: a Six Step Approach. JHU; 1998. p. 202.
Groos J, Walter A, Wittek A, Strizek B, Gembruch U, Recker F. Shaping ultrasound in midwifery: towards an evidence-based training framework for enhanced prenatal care. Arch Gynecol Obstet. 2024;310(1):23–43.
doi: 10.1007/s00404-024-07558-3
Dietrich CF, Sirli RL, Barth G, Blaivas M, Daum N, Dong Y et al. Student ultrasound education - current views and controversies. Ultraschall Med Stuttg Ger. 1980. 2024;45(4):389–94.
Barth G, Prosch H, Blaivas M, Gschmack AM, Hari R, Hoffmann B et al. Student Ultrasound Education, Current Views and Controversies; Who Should be Teaching? Z Für Gastroenterol [Internet]. 2024 Jul 29 [cited 2024 Aug 7]; https://www.thieme-connect.de/products/ejournals/abstract/ https://doi.org/10.1055/a-2356-7906
International Confederation of Midwives. Essential competencies for midwifery practice [Internet]. 2019 [cited 2024 Jul 19]. https://www.internationalmidwives.org/wp-content/uploads/icm-competencies-en-print-october-2019_final_18-oct-5db05248843e8.pdf
Deutscher Hebammenverband e.V. (DHV). Kompetenzen von Hebammen - Anhang 1 zur Stellungnahme HebStPrV [Internet]. 2019 [cited 2024 Apr 20]. https://hebammenverband.de/wp-content/uploads/2021/02/2019-09-13_DHV_Kompetenzen_von_Hebammen_Anhang_1_zur_Stellungnahme_HebStPrV.pdf
Salomon Lj, Alfirevic Z, Da Silva Costa F, Deter Rl, Figueras F, Ghi T, et al. ISUOG Practice guidelines: ultrasound assessment of fetal biometry and growth. Ultrasound Obstet Gynecol. 2019;53(6):715–23.
doi: 10.1002/uog.20272
Ghi T, Eggebø T, Lees C, Kalache K, Rozenberg P, Youssef A, et al. ISUOG Practice guidelines: intrapartum ultrasound. Ultrasound Obstet Gynecol. 2018;52(1):128–39.
doi: 10.1002/uog.19072
Savoia P, Jayanthi SK, Chammas MC. Focused Assessment with Sonography for Trauma (FAST). J Med Ultrasound. 2023;31(2):101–6.
doi: 10.4103/jmu.jmu_12_23
Hall EA, Matilsky D, Zang R, Hase N, Habibu Ali A, Henwood PC, et al. Analysis of an obstetrics point-of-care ultrasound training program for healthcare practitioners in Zanzibar, Tanzania. Ultrasound J. 2021;13:18.
doi: 10.1186/s13089-021-00220-y
Bidner A, Bezak E, Parange N. Evaluation of antenatal point-of-care ultrasound training workshops for rural/remote healthcare clinicians: a prospective single cohort study. BMC Med Educ. 2022;22:906.
doi: 10.1186/s12909-022-03888-5
Bentley S, Hexom B, Nelson BP. Evaluation of an Obstetric Ultrasound Curriculum for midwives in Liberia. J Ultrasound Med. 2015;34(9):1563–8.
doi: 10.7863/ultra.15.14.08017
Vinayak S, Sande J, Nisenbaum H, Nolsøe CP. Training midwives to perform Basic Obstetric Point-of-care Ultrasound in Rural areas using a tablet platform and mobile phone Transmission Technology—A WFUMB COE Project. Ultrasound Med Biol. 2017;43(10):2125–32.
doi: 10.1016/j.ultrasmedbio.2017.05.024
Johnston BK. Evaluation of Point of Care Ultrasound Training for Midwives [Internet] [Thesis]. 2021 [cited 2024 Aug 1]. http://hdl.handle.net/11375/26969
Gueneuc A, De Garnier J, Dommergues M, Rivière M, Ville Y, Chalouhi GE. Impact de l’intégration de la simulation en échographie obstétricale dans le cursus des étudiants sages-femmes. Gynécologie Obstétrique Fertil Sénologie. 2019;47(11):776–82.
doi: 10.1016/j.gofs.2019.07.004
Shaw-Battista J, Young-Lin N, Bearman S, Dau K, Vargas J. Interprofessional Obstetric Ultrasound Education: successful development of Online Learning modules; Case-based seminars; and Skills Labs for registered and Advanced Practice Nurses, midwives, Physicians, and trainees. J Midwifery Womens Health. 2015;60(6):727–34.
doi: 10.1111/jmwh.12395
Nathan RO, Swanson JO, Swanson DL, McClure EM, Bolamba VL, Lokangaka A, et al. Evaluation of focused Obstetric Ultrasound examinations by Health Care Personnel in the Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia. Curr Probl Diagn Radiol. 2017;46(3):210–5.
doi: 10.1067/j.cpradiol.2016.11.001
Santana EFM, Castello RG, Passos MET, Ribeiro GCF, Araujo Júnior E. How to Reach the best Ultrasound performance in the delivery room. Rev Bras Ginecol E Obstetrícia. 2023;44:1070–7.
Ghose I, Chelliah A, Gordon R, Andrade EH, Refuerzo J, Blackwell SC, et al. 1136 the FAST exam in obstetrics: a feasibility study. Am J Obstet Gynecol. 2021;224(2):S700–1.
doi: 10.1016/j.ajog.2020.12.1160
Rozenberg P, Porcher R, Salomon LJ, Boirot F, Morin C, Ville Y. Comparison of the learning curves of digital examination and transabdominal sonography for the determination of fetal head position during labor. Ultrasound Obstet Gynecol. 2008;31(3):332–7.
doi: 10.1002/uog.5267
Shah S, Santos N, Kisa R, Mike Maxwell O, Mulowooza J, Walker D, et al. Efficacy of an ultrasound training program for nurse midwives to assess high-risk conditions at labor triage in rural Uganda. PLoS ONE. 2020;15(6):e0235269.
doi: 10.1371/journal.pone.0235269

Auteurs

Julia Groos (J)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Adeline Walter (A)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Ruben Plöger (R)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Brigitte Strizek (B)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Ulrich Gembruch (U)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Agnes Wittek (A)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.

Florian Recker (F)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany. florian.recker@ukbonn.de.

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