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Categorizing Fetal Heart Rate Variability with and without Visual Aids.

Amanda J Ashdown¹, Mark W Scerbo¹, Lee A Belfore²

¹Department of Psychology, Old Dominion University, Norfolk, Virginia.

|October 11, 2016

Summary

Clinicians correctly categorized fetal heart rate (FHR) variability images more accurately when they were near the center of NICHD ranges and when visual exemplars were used. Training with visual aids can improve FHR interpretation and enhance labor and delivery safety.

Keywords:

categorization clinical judgment cues exemplars fetal heart rate variability

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Area of Science:

Obstetrics and Gynecology
Perinatal Medicine
Clinical Decision Making

Background:

Accurate interpretation of fetal heart rate (FHR) variability is crucial for fetal well-being during labor.
The National Institute of Child Health and Human Development (NICHD) provides standardized categories for FHR variability.
Clinician performance in categorizing FHR variability can be influenced by the clarity of examples and the availability of reference materials.

Observation:

Clinicians demonstrated higher accuracy in categorizing FHR variability when images fell near the center of NICHD-defined ranges compared to boundaries.
The use of visual exemplars significantly improved clinicians' accuracy in categorizing FHR variability.
Clinicians outperformed novices in accuracy and speed, particularly in the absence of exemplars.

Findings:

FHR variability categorization accuracy is significantly better for images near range centers (p < 0.001).
The availability of exemplars enhances FHR variability categorization accuracy (p = 0.007).
Expert clinicians showed improved performance over novices, especially without visual aids.

Implications:

Categorizing FHR variability is challenging when examples are near the boundaries of NICHD ranges.
Visual aids and targeted training can enhance clinicians' ability to interpret FHR variability accurately.
Improved FHR interpretation through training may lead to enhanced safety during labor and delivery.