Medical education in fetal echocardiography for OB/GYN residents

Prenatal detection of congenital heart defects (CHD) depends heavily on operator skill. OB/GYN residents are primary providers of screening, yet training in fetal echocardiography is heterogeneous and frequently insufficient, contributing to suboptimal detection in routine care.

To synthesize current evidence and practice on educating OB/GYN residents in fetal echocardiography, evaluate educational modalities (didactics, mentorship, simulation, e-learning), identify gaps, and propose curriculum recommendations.

Narrative review of European and international guidelines, training surveys, and empirical studies on ultrasound education with emphasis on fetal cardiac screening. Sources included society curricula (e.g., ISUOG, FMF, national colleges), multicenter training initiatives, simulation trials, and competency-based education literature. Findings were organized along the IMRaD structure and triangulated to derive practical recommendations.

Training structures vary widely in objectives, volume requirements, supervision, and assessment. Successful national/regional programs show that targeted workforce training can raise antenatal CHD detection and improve neonatal outcomes. High-fidelity simulation consistently accelerates skill acquisition: novices achieved > 95 % correct standard fetal cardiac views within two weeks and matched or exceeded untrained physicians' scanning times after six weeks. Blended models that combine structured didactics (FMF/ISUOG), deliberate simulator practice with guided feedback, mentored clinical scanning, and case-based e-learning yield the most reliable gains. Persistent barriers include limited protected time, uneven instructor expertise, scarce access to simulators, ethical/logistical constraints for hands-on practice, and inadequate competency assessment tools.

A standardized, competency-based curriculum for OB/GYN residents-embedding mandatory theoretical modules, simulation-based milestones, supervised clinical logbooks with image portfolios, and objective practical assessments-can meaningfully elevate fetal echocardiography proficiency and, by extension, CHD detection in routine obstetric care. Implementation should be supported by faculty development, regional simulation networks, and continuous quality improvement linking training metrics to clinical outcomes.