Improvings: Implementing a Protocol to Improve Intrapartum Sonography Skills.
ConditionObstetric Labor
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
AgeNot listed
SponsorUniversitaire Ziekenhuizen KU Leuven
About this trial
Prospective observational cohort study on the learning curve for the sonographic assessment of labor progress (fetal head position and station) amongst obstetric caregivers.
Study participants: convenience sample of 20 obstetric caregivers working in the department of obstetrics and gynecology at the University Hospital of Leuven - recruited over a 12-month period.
Format of the training program:
1. Observational phase: the goal is to measure the accuracy of the clinical assessment of fetal head position and station throughout the different stages of labor by caregivers working within the department. 2. Self-study: reading of the 2018 practice guidelines on intra-partum ultrasound by ISUOG and watching the corresponding teaching video. 3. Supervised implementation phase: one-to-one teaching by experienced sonographers, who initially demonstrate, later interactively supervise the quality of the scans acquired by the obstetric caregiver. 4. Proficiency testing: from this point onwards, the trainee independently performs ultrasound scans in labor to asses fetal head position and station. The scans will be repeated by the expert sonographer, the results will be compared (qualitatively and quantitatively) and immediate feedback provided if indicated. Every observation will have a binary outcome (success or failure of trainee acquisition) according to predefined quality assessment criteria. Observations will be continued until proficiency is reached (saturation of the learning curve).
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Obstetric caregivers, willing to participate in the study (to give written informed consent).
Disqualifiers
Trainees refusing to participate (refusing to give written informed consent).
Trial population
Obstetric caregivers working within the department of obstetrics and gynecology at the University Hospital of Leuven.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Not listed
Trial groups
No trial groups listed
Trial outcomes
Primary outcomes
1
Proficiency for the sonographic assessment of fetal head station during labor.
Number of ultrasound examinations a caregiver needs to perform under expert supervision to obtain proficiency - defined as the CUSUM (Cumulative Sum analysis) performance graph dropping below two consecutive boundary lines.
Time frame
Through study completion, estimated at 12 months.2
Proficiency for the sonographic assessment of fetal head position during labor.
Number of ultrasound examinations a caregiver needs to perform under expert supervision to obtain proficiency - defined as the CUSUM (Cumulative Sum analysis) performance graph dropping below two consecutive boundary lines.
Time frame
Through study completion, estimated at 12 months.Secondary outcomes
1
Knowledge, attitude and practices regarding intrapartum ultrasound use.
Changes in KAP (Knowledge, Attitude and Practice) survey scores throughout the completion of the training program. Higher scores indicate better knowledge or a more favorable opinion regarding intrapartum ultrasound use (attitude, practice) - lower scores the opposite. * Knowledge survey: 5 questions on the sonographic assessment of fetal head station (score ranging from 0-5/5), 5 questions on the sonographic assessment of fetal head position (score ranging from 0-5/5). * Attitude: 6 questions, score ranging from 0-6/6. * Practice: 6 questions, score ranging from 0-6/6. * One Likert scale on confidence level regarding sonographic assessment of fetal head station (score ranging 0-5/5, 0 indicating "not confident at all", 5/5 "very confident") * One Likert scale on confidence level regarding sonographic assessment of fetal head position (score ranging 0-5/5, 0 indicating "not confident at all", 5/5 "very confident")
Time frame
Assessed at three timepoints: once at inclusion, once after the training phase (esimated three months after inclusion) and one final assessment at completion of the training program (when proficiency is declared, estimated at 6 months).2
Differences in learning curves according to training level (years of residency / clinical experience).
By visual inspection/comparison of learning curves/CUSUM graphs.
Time frame
On study completion, estimated at 12 months.3
Differences in learning curves for the sonographic assessment of fetal head station vs. fetal head position.
By visual inspection/comparison of learning curves/CUSUM graphs.
Time frame
On study completion, estimated at 12 months.4
Delta-AoP (Angle of Progression)
Differences between the (AoP trainee) and (AoP expert sonographer)/observation longitudinally plotted in time.
Time frame
On study completion, estimated at 12 months.Sponsors and contacts
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Source ClinicalTrials.gov