Up or down?: A randomized trial comparing image orientations during transvaginal ultrasound training

Caroline Taksøe-Vester; Eva Dreisler; Lisbeth A Andreasen; Liv Dyre; Charlotte Ringsted; Ann Tabor; Martin G Tolsgaard

doi:10.1111/aogs.13444

Up or down? A randomized trial comparing image orientations during transvaginal ultrasound training

Caroline Taksøe-Vester, Eva Dreisler, Lisbeth A Andreasen, Liv Dyre, Charlotte Ringsted, Ann Tabor, Martin G Tolsgaard

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

INTRODUCTION: There is no international consensus on the orientation of transvaginal ultrasound images and no evidence exists to support the superiority of one image orientation over the other. The aim of this study was to compare learning curves and skills transfer in a group of novices randomized to top-down or bottom-up image orientation, and to determine whether individual preferences for image orientation affect learning and skills transfer.

MATERIAL AND METHODS: 60 senior medical students, with no prior ultrasound experience, were randomized to orient the image top-down or bottom-up during training on an ultrasound simulator until attaining expert levels of performance. Participants then completed a transfer test involving a systematic ultrasound examination on a physical mannequin using real ultrasound equipment. Performance was assessed during the transfer test by two independent raters using the objective structured assessment of ultrasound skills (OSAUS) score and a global rating score.

RESULTS: The bottom-up group reached the expert level with significantly fewer attempts than did the top-down group [median ± interquartile range: 4 ± 2 vs 5 ± 3] (U = 285.5, P = 0.014). The bottom-up group used less time to achieve the expert level (median ± interquartile range: 3 h 2 m ± 1 h 14 m vs 3 h 28 m ± 2 h 21 m) (U = 301.5, P = 0.029). The two groups performed similarly during the transfer test with respect to their OSAUS scores (top-down 56.7% vs bottom-up 53.2%, P = 0.13). The global rating scores were higher in the top-down group (top-down 57.1% vs bottom-up 50.0%, P = 0.02).

CONCLUSIONS: Orientation of the images bottom-up rather than top-down, led to a steeper learning curve, but had little or no impact on the subsequent transfer of skills.

Original language	English
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	97
Issue number	12
Pages (from-to)	1455-1462
Number of pages	8
ISSN	0001-6349
DOIs	https://doi.org/10.1111/aogs.13444
Publication status	Published - Dec 2018

Keywords

Clinical Competence
Denmark
Education, Medical, Undergraduate/methods
Female
Gynecology/education
Humans
Learning Curve
Simulation Training
Ultrasonography/methods
Vagina/diagnostic imaging

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Cite this

@article{ab856dcfd979433d9808c20ddc2ac12b,

title = "Up or down?: A randomized trial comparing image orientations during transvaginal ultrasound training",

abstract = "INTRODUCTION: There is no international consensus on the orientation of transvaginal ultrasound images and no evidence exists to support the superiority of one image orientation over the other. The aim of this study was to compare learning curves and skills transfer in a group of novices randomized to top-down or bottom-up image orientation, and to determine whether individual preferences for image orientation affect learning and skills transfer.MATERIAL AND METHODS: 60 senior medical students, with no prior ultrasound experience, were randomized to orient the image top-down or bottom-up during training on an ultrasound simulator until attaining expert levels of performance. Participants then completed a transfer test involving a systematic ultrasound examination on a physical mannequin using real ultrasound equipment. Performance was assessed during the transfer test by two independent raters using the objective structured assessment of ultrasound skills (OSAUS) score and a global rating score.RESULTS: The bottom-up group reached the expert level with significantly fewer attempts than did the top-down group [median ± interquartile range: 4 ± 2 vs 5 ± 3] (U = 285.5, P = 0.014). The bottom-up group used less time to achieve the expert level (median ± interquartile range: 3 h 2 m ± 1 h 14 m vs 3 h 28 m ± 2 h 21 m) (U = 301.5, P = 0.029). The two groups performed similarly during the transfer test with respect to their OSAUS scores (top-down 56.7% vs bottom-up 53.2%, P = 0.13). The global rating scores were higher in the top-down group (top-down 57.1% vs bottom-up 50.0%, P = 0.02).CONCLUSIONS: Orientation of the images bottom-up rather than top-down, led to a steeper learning curve, but had little or no impact on the subsequent transfer of skills.",

keywords = "Clinical Competence, Denmark, Education, Medical, Undergraduate/methods, Female, Gynecology/education, Humans, Learning Curve, Simulation Training, Ultrasonography/methods, Vagina/diagnostic imaging",

author = "Caroline Taks{\o}e-Vester and Eva Dreisler and Andreasen, {Lisbeth A} and Liv Dyre and Charlotte Ringsted and Ann Tabor and Tolsgaard, {Martin G}",

note = "{\textcopyright} 2018 Nordic Federation of Societies of Obstetrics and Gynecology.",

year = "2018",

month = dec,

doi = "10.1111/aogs.13444",

language = "English",

volume = "97",

pages = "1455--1462",

journal = "Acta Obstetricia et Gynecologica Scandinavica",

issn = "0001-6349",

publisher = "JohnWiley & Sons Ltd",

number = "12",

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T1 - Up or down?

T2 - A randomized trial comparing image orientations during transvaginal ultrasound training

AU - Taksøe-Vester, Caroline

AU - Dreisler, Eva

AU - Andreasen, Lisbeth A

AU - Dyre, Liv

AU - Ringsted, Charlotte

AU - Tabor, Ann

AU - Tolsgaard, Martin G

PY - 2018/12

Y1 - 2018/12

N2 - INTRODUCTION: There is no international consensus on the orientation of transvaginal ultrasound images and no evidence exists to support the superiority of one image orientation over the other. The aim of this study was to compare learning curves and skills transfer in a group of novices randomized to top-down or bottom-up image orientation, and to determine whether individual preferences for image orientation affect learning and skills transfer.MATERIAL AND METHODS: 60 senior medical students, with no prior ultrasound experience, were randomized to orient the image top-down or bottom-up during training on an ultrasound simulator until attaining expert levels of performance. Participants then completed a transfer test involving a systematic ultrasound examination on a physical mannequin using real ultrasound equipment. Performance was assessed during the transfer test by two independent raters using the objective structured assessment of ultrasound skills (OSAUS) score and a global rating score.RESULTS: The bottom-up group reached the expert level with significantly fewer attempts than did the top-down group [median ± interquartile range: 4 ± 2 vs 5 ± 3] (U = 285.5, P = 0.014). The bottom-up group used less time to achieve the expert level (median ± interquartile range: 3 h 2 m ± 1 h 14 m vs 3 h 28 m ± 2 h 21 m) (U = 301.5, P = 0.029). The two groups performed similarly during the transfer test with respect to their OSAUS scores (top-down 56.7% vs bottom-up 53.2%, P = 0.13). The global rating scores were higher in the top-down group (top-down 57.1% vs bottom-up 50.0%, P = 0.02).CONCLUSIONS: Orientation of the images bottom-up rather than top-down, led to a steeper learning curve, but had little or no impact on the subsequent transfer of skills.

AB - INTRODUCTION: There is no international consensus on the orientation of transvaginal ultrasound images and no evidence exists to support the superiority of one image orientation over the other. The aim of this study was to compare learning curves and skills transfer in a group of novices randomized to top-down or bottom-up image orientation, and to determine whether individual preferences for image orientation affect learning and skills transfer.MATERIAL AND METHODS: 60 senior medical students, with no prior ultrasound experience, were randomized to orient the image top-down or bottom-up during training on an ultrasound simulator until attaining expert levels of performance. Participants then completed a transfer test involving a systematic ultrasound examination on a physical mannequin using real ultrasound equipment. Performance was assessed during the transfer test by two independent raters using the objective structured assessment of ultrasound skills (OSAUS) score and a global rating score.RESULTS: The bottom-up group reached the expert level with significantly fewer attempts than did the top-down group [median ± interquartile range: 4 ± 2 vs 5 ± 3] (U = 285.5, P = 0.014). The bottom-up group used less time to achieve the expert level (median ± interquartile range: 3 h 2 m ± 1 h 14 m vs 3 h 28 m ± 2 h 21 m) (U = 301.5, P = 0.029). The two groups performed similarly during the transfer test with respect to their OSAUS scores (top-down 56.7% vs bottom-up 53.2%, P = 0.13). The global rating scores were higher in the top-down group (top-down 57.1% vs bottom-up 50.0%, P = 0.02).CONCLUSIONS: Orientation of the images bottom-up rather than top-down, led to a steeper learning curve, but had little or no impact on the subsequent transfer of skills.

KW - Clinical Competence

KW - Denmark

KW - Education, Medical, Undergraduate/methods

KW - Female

KW - Gynecology/education

KW - Humans

KW - Learning Curve

KW - Simulation Training

KW - Ultrasonography/methods

KW - Vagina/diagnostic imaging

U2 - 10.1111/aogs.13444

DO - 10.1111/aogs.13444

M3 - Journal article

C2 - 30132792

SN - 0001-6349

VL - 97

SP - 1455

EP - 1462

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 12

ER -

Up or down? A randomized trial comparing image orientations during transvaginal ultrasound training

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Keywords

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