Ureter Visualization With Transvaginal Ultrasound: A Learning Curve Study

Area of Science:

• Gynecologic Surgery
• Medical Education
• Diagnostic Imaging

Background:

• Transvaginal ultrasound (TVUS) is crucial for gynecologic procedures.
• Accurate ureter identification during TVUS is essential for patient safety.
• The learning curve for fellows to master this skill requires evaluation.

Purpose of the Study:

• To assess the learning curve for gynecologic surgical fellows identifying ureters via TVUS.
• To determine the number of TVUS examinations needed to achieve competency.
• To evaluate the effectiveness of current training models.

Main Methods:

• Prospective study at two Australian centers (December 2017-December 2018).
• Three fellows (F1-F3) with varying prior ultrasound experience participated.
• Fellows performed focused ureter identification post-expert TVUS, receiving immediate feedback; cumulative summation analysis tracked learning curves.

Main Results:

• 150 TVUS examinations were performed on 145 patients.
• Fellow F1 did not reach competency within 50 examinations.
• Fellows F2 and F3 reached competency after 41 and 31 examinations, respectively.

Conclusions:

• Learning TVUS ureter identification is feasible for fellows.
• Competency is not guaranteed within a fixed number of scans.
• An individualized, competency-based medical education model is advocated for ultrasound training.