Evaluation of the Published Obstetrics and Gynecology Ultrasound Curriculum Based Upon Expert Consensus Recommendations

Purpose: In 2018, experts published recommendations for training and assessing obstetric and gynecologic ultrasound skills in residency programs¹. This report evaluates the effectiveness of these recommended guidelines among various practitioners. Methods: Few attempts have been made to develop specific courses based on guidelines from the consensus recommendations. On May 1, 2022, obgyncourses.com published an online curriculum of 18 narrated video courses covering 26 topics that followed all published recommendations. These courses were approved for 32 AMA PRA Category I Credit (s)™ and were available to all practitioners for a small fee. Identical courses are permanently available without charge on obimages.net and YouTube (https://www.youtube.com/channel/UCQyjGyf2dFRPFXqLx-GbXww). The program consisted of 18 video courses, each comprising text, images, and voice-over videos, with an average video duration of 14 minutes. Four levels of difficulty covered the recommended topics. In addition, guided by consensus recommendations, free competency quizzes were made available online. https://obgyncourses.com/competency-quizzes-usefulness/ In total, 68 students were enrolled and completed 578 courses. After each course, a quiz was undertaken, and a pass rate of 70% was required to proceed to the next unit. The score for each completed course was calculated, and a survey was conducted to evaluate the course content and student satisfaction levels. The demographic profile of the participants was assessed, and a statistical analysis was performed to assess the variation in performance among individual courses and the survey results. Results: Among the 68 students, 38.2% were practicing ultrasound technicians, followed by Ob/Gyn residents (24%), OB/Gyn practicing physicians (17.6%), and perinatology fellows or practicing perinatologists (4.4%). Private practice Ob/Gyn (24%) and academic-based practice (22.1%) were the most common work environments, followed by hospital-based Ob/Gyn Clinic (13.2%), hospital-based perinatology Clinic (13.2%), and radiology-based clinics (5.9%). The Level 1 course had the highest mean scores with “Aspects of Exam” (86.1%), “Characteristics of Ultrasound Equipment” (89.4%), and “Official Statements” (86.2%). The standard deviations ranged from 6.7 to 11.7, indicating different degrees of dispersion of student scores from the mean across different courses. Independent t-tests were conducted to compare the courses with low scores to the average score of all courses. Four courses had significantly lower scores than the other courses. These courses were Level 1, “First Trimester,” Level 2, “Major Malformations in Early Gestation,” Level 2, “Sonographic Evaluation of The Uterus,” and Level 2, “The Placenta.” The mean score for the Level 1 “First-trimester” course was 81.9%, while the average score of all other courses was 86.9% (p=.001). The other courses with lower scores were Level 2, “Major Malformations in Early Gestation” (p=.001 with a mean score of 82.7%), Level 2, “Sonographic Evaluation of The Uterus” (p=.001 with a mean score of 80%), and Level 2 “The Placenta” (p=0.019 with mean score 82.3%). Importantly, students who performed well on the normal anatomy of the fetal heart course also scored well on the fetal cardiac malformations course. Sixteen students completed the free competency quiz. Their scores range from a minimum of 78.8% to a maximum of 92.3%, with a mean (average) score of 85%. Four survey questions were necessary for course completion: 1. Were these courses an effective review of my level of learning? 2. Were the courses evidence-based and necessary for my learning level? 3. Did these courses enhance my current knowledge base? 4. Were these courses fair, balanced, objective, and free of bias? 3. 3. Did these courses enhance my current knowledge base? 4. 4. Were these courses fair, balanced, objective, and free of bias? The participant choices were strongly disagreed, disagreed, neutral, agree, and strongly agree. More than 80% of the respondents agreed or strongly agreed with each survey question. In addition, the survey questions were arranged on a Likert scale, and the averages were made into a single variable for each course. Using this method, course satisfaction levels were high. With a maximum score of 5.0, Level 1 courses showed an average satisfaction level of 4.49, Level 2 showed a satisfaction score of 4.53, and Level 3 scored 4.27. Conclusions: The consensus group’s curriculum and competency suggestions were valuable for practitioners and trainee residents. The dispersion of mean scores across different courses varied, indicating differences in the difficulty level of course content. This suggests a need for course design modifications, particularly for the first trimester, major malformations in early gestation, sonographic evaluation of the uterus, and advanced placental topics. Overall, the satisfaction levels were high in each category of survey questions.