Smart phone based obstetric tele-mentored ultrasound performed through filipino medical students

SMART PHONE BASED OBSTETRIC TELE-MENTORED ULTRASOUND PERFORMED THROUGH FILIPINO MEDICAL STUDENTS Reynan Hernandez, MD, FPCR, FUSP, MMHoA, Jeremie Bartelheimer, MD-MBA, Jake Batuhan, MD-MBA, Michael Cootauco, MD-MBA, Adriel Laurenz Tan, MD, Airen Sigue, MD, MBAH, FPOGS, FPSUOG, Florentina Villanueva, MD, FPOGS, FPSUOG, Kate Wad-asen, MD-MBA, Background: Maternal and neonatal mortality remain significant public health challenges, particularly in geographically isolated and disadvantaged areas (GIDA). The accessibility of obstetric ultrasound in these settings is limited due to a lack of trained personnel. Tele-ultrasound, particularly real-time mentored tele-ultrasound (RTMTUS), has emerged as a promising solution. This study examines the feasibility of smartphone-based obstetric tele-mentored ultrasound performed by medical students with no prior ultrasound training. Methods: A single-blinded randomized controlled trial was conducted among 48 medical students from a private medical school in the Philippines. Participants were divided into two groups: guided group that received real-time remote mentorship from an obstetric-sonologist and non-guided group that performed ultrasound scans independently post-online training. All participants underwent two sessions of online training before performing obstetric ultrasounds on a simulation model (HANA MW48). The scans were evaluated based on a predefined checklist, and pre- and post-test assessments were conducted to measure knowledge acquisition. Mann-Whitney U tests, Chi-square tests, and paired t-tests were used to compare differences and learning outcomes. Results: The guided group demonstrated significantly higher accuracy in performing ultrasound scans compared to the non-guided group in categories such as applied knowledge of ultrasound equipment, systematic examination, image interpretation, documentation, and medical decision-making (p < 0.05). However, no significant difference was observed in the ability to identify fetal heart activity, fetal presentation, and fetal number between the two groups. The guided group performed slightly better in assessing placental location and amniotic fluid volume, but the differences were not statistically significant. Pre-test and post-test assessments showed a significant improvement in knowledge scores among all participants (p < 0.0001). Conclusion: Smartphone-based obstetric tele-mentored ultrasound is a feasible and effective training method for inexperienced medical students. Real-time expert guidance enhances ultrasound accuracy, particularly in complex diagnostic aspects. This approach could be valuable in expanding access to obstetric ultrasound in underserved areas where trained personnel are scarce. Further research is recommended to evaluate its implementation among midwives and rural healthcare providers in real-world clinical settings.