To guide or not to guide: A randomized study on the use of needle guide for chorionic villus sampling training

Area of Science:

• Medical Education
• Prenatal Diagnostics
• Surgical Skills Training

Background:

• Chorionic villus sampling (CVS) is an invasive prenatal diagnostic procedure for fetal genetic anomalies.
• Noninvasive prenatal testing (NIPT) is increasingly replacing CVS, challenging skill maintenance for trainees.
• Optimal training methods for ultrasound-guided CVS remain uncertain.

Purpose of the Study:

• To evaluate the effectiveness of different training strategies for ultrasound-guided CVS.
• To compare skill acquisition and performance using context variation, needle-guided, and freehand techniques.
• To assess skill transfer among novices in ultrasound-guided CVS.

Main Methods:

• A randomized controlled trial involving 101 ultrasound novices allocated into three training groups.
• Participants underwent a 1-hour training session on ballistic gel models using ultrasound-guided needle punctures.
• Post-training, participants completed CVS transfer tests on a simulator manikin, evaluated by blinded expert raters.

Main Results:

• No significant differences in overall performance scores were found among the three training groups.
• Procedural performance significantly improved during transfer tests when participants utilized needle guides.
• Needle guides enhanced scores for ultrasound assessment, insertion site selection, sampling technique, and overall performance.

Conclusions:

• Training approaches (needle-guided, freehand, context variation) showed no significant difference in learning ultrasound-guided CVS.
• Incorporating needle guides into CVS training may promote safer practice for novice learners.
• Needle guides offer a potential solution for skill development amid decreasing clinical training opportunities.