DEVELOPMENT AND ASSESSMENT OF A NOVEL SIMULATION FOR ULTRASOUND-GUIDED FAMILY PLANNING INJECTION PROCEDURES

Objectives

We aimed to create and evaluate a simulation for ultrasound-guided family planning injection procedures including feticidal injections.

Methods

We created a simulation model with a gelatin mold containing water balloons. All participants completed a pre-simulation survey regarding previous training and current practice with US-guided procedures. Participants then completed a didactic session on feticidal injections and ultrasound-guided procedure principles. Participants oriented to the simulation tasks and completed three attempts to identify target and place needle into the target to withdraw/inject. They were evaluated on successful completion as well as: correct probe positioning, lining up target, early visualization of needle, needle visualization throughout the entire task, and time to completion. Participants completed a post-simulation survey evaluating the simulation and its impact on their practice.

Results

Seven participants completed the simulation: four Complex Family Planning (CFP) Attendings, two CFP fellows and one third year obstetrician gynecologist (Ob-Gyn) resident. In the pre-simulation survey, ultrasound-guided procedures were reported as part of the current practice for all participants except the resident. During the simulation itself, participants reliably completed all tasks successfully. The range of time for task completion varied from 16 seconds to 180 seconds and was notable for the deeper balloons being more challenging to access quickly. In the post-simulation survey, all participants rated the course as excellent, and agreed that they felt more comfortable offering US guided injections as part of their practice after this course.

Conclusions

We have constructed a didactic simulation that incorporates the core skills necessary for providing safe ultrasound-guided family planning procedures, including feticidal injections.