ACES: Accurate Cervical Evaluation With Sonography

ACES: Accurate Cervical Evaluation With Sonography

Objectives Transvaginal sonographic cervical length screening is an important tool for the evaluation of preterm labor. However, a structured curriculum is lacking in obstetrics and gynecology residency programs. The Accurate Cervical Evaluation with Sonography (ACES) program was developed to addres...

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Published in:Journal of ultrasound in medicine Vol. 35; no. 1; pp. 25 - 28
Main Authors: Chory, Margaret K., Schnettler, William T., March, Melissa, Hacker, Michele R., Modest, Anna M., Rodriguez, Diana
Format: Journal Article
Language:English
Published: England American Institute of Ultrasound in Medicine 01-01-2016
Subjects:
Boston
cervical length
Cervical Length Measurement - methods
Clinical Competence
Curriculum
Educational Measurement
Humans
Internship and Residency - organization & administration
obstetric ultrasound
Obstetrics - education
Reproducibility of Results
Sensitivity and Specificity
Teaching - methods
transvaginal sonography
Ultrasonography, Prenatal
ultrasound education
Young Adult
Boston
ultrasound education
obstetric ultrasound
transvaginal sonography
cervical length
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Summary:Objectives Transvaginal sonographic cervical length screening is an important tool for the evaluation of preterm labor. However, a structured curriculum is lacking in obstetrics and gynecology residency programs. The Accurate Cervical Evaluation with Sonography (ACES) program was developed to address this deficiency and combines an online didactic course with a standardized performance assessment of live scans. We sought to evaluate the effectiveness of the ACES program to teach residents sonographic cervical length assessment. Methods All obstetrics and gynecology residents at our institution were invited to participate from 2012 to 2013. The program consisted of an initial supervised transvaginal cervical evaluation, an online didactic course and written examination, and 5 subsequent supervised scans. The instructor performed an independent cervical length measurement at each encounter. The primary outcome was the difference in cervical length measurement between the resident and instructor. We hypothesized that this difference would decrease over time. At each visit, a 10‐item checklist was used for skill assessment. Comparisons of checklist scores over time were also performed. Results Seventeen of 20 residents completed at least some of the training, and 10 completed the entire program. The median difference in cervical length measurement between residents and instructors at posttests 3, 4, and 5 improved significantly compared to the pretest scan (all P≤ .02). Similarly, the checklist scores improved over time (all P ≤ .0008). Conclusions Transvaginal cervical sonography is an important tool in the evaluation of preterm labor. The ACES program provides residents a structured curriculum for cervical evaluation and supervisors a standardized means of evaluating trainees' skills.
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ISSN:0278-4297
1550-9613
DOI:10.7863/ultra.15.01090