Development of a novel task trainer for second trimester ultrasound-guided uterine evacuation

Second trimester surgical termination of pregnancy by dilation and evacuation (D&E) is a procedure that the Obstetrics and Gynecology (OB/GYN) Residency Review Committee requires training programs to offer to their residents and that many residents desire to learn. However, because of limited numbers of credentialed providers, clinical training opportunities may be limited or not available at their training institutions. Simulated procedures may allow for residents and other learners to be more prepared and capable at the time of their first clinical procedures or advanced skill acquisition.

We describe the construction of a low-cost task trainer for simulation of ultrasound-guided second trimester uterine evacuation procedures using a preserved pig heart and fetal pig. Residents of OB/GYN used the task trainer and completed a survey to determine its effectiveness as a teaching tool.

With the use of a 5-point Likert scale survey (1 inferior, 5 superior), 13 OB/GYN trainees felt that the task trainer reliably reproduced fetal extraction (4.08), would improve their clinical skills (4.46), and would allow them to obtain the skills required to perform the task in real life (4.38). The similarity of ultrasound images to real-life images had a mean score of 3.69. Additional comments about the usefulness of this task trainer in learning the skills necessary for D&E procedures from the participants were overall positive.

The task trainer for ultrasound-guided second trimester uterine evacuation showed excellent face validity. This low-cost task trainer provides residents and other trainees with a tool to practice ultrasound-guided fetal extraction skills and improve proficiency with D&E outside the operating room. In addition, it increases their confidence in being able to perform the procedure on patients.