Improving OB/GYN Resident Ultrasound Education Through a Simulation-Based Curriculum

Ultrasound is a fundamental skill of practicing obstetrician-gynecologists with proficiency ideally obtained in training. However, ultrasound training in residency has not been standardized and varies based on clinical experience and the number of ultrasounds performed. Simulation provides a way to standardize training while incorporating hands-on skills. This study evaluated the effects of a simulation-based ultrasound curriculum on resident confidence and the number of cases logged.  Methods: This is a prospective study comparing the differences in end-of-year postgraduate year 1 (PGY1) obstetric/gynecology (OB/GYN) resident confidence and case logs in ultrasonography with and without a simulation curriculum. PGY1 residents from the 2022-2023 cohort did not train on a simulation curriculum prior to the start of their clinical training, while the PGY1 residents from the 2023-2024 class underwent both curricular training and simulated image capture. Although some residents may have had some didactic exposure to ultrasound in medical school, that experience was not taken into account. Both groups had confidence scores and case logs obtained at the end of their PGY1 year. Paired Student t-tests were performed.  Results: The 2022-2023 cohort performed on average 153 transvaginal and 29 obstetric sonograms. The 2023-2024 cohort performed on average 130 transvaginal and six obstetric sonograms. The end-of-year questionnaire showed no significant difference in ultrasound confidence between the two cohorts (all items p > 0.17).  Conclusions: Although the class that underwent simulation training had fewer ultrasound numbers per resident, they showed confidence ratings similar to the class with more cases. With simulation, fewer clinical sonograms may be needed to achieve the same confidence level. A standardized simulation curriculum could be a helpful adjunct to residency programs to address variance in clinical ultrasound training, and a larger-scale study to confirm these preliminary findings would be justified.