Teaching ultrasound-guided invasive procedures in fetal medicine: learning curves with and without an electronic guidance system

Objective To compare the learning curves of inexperienced junior obstetrics/gynecology registrars for ultrasound-guided invasive procedures on a training Model, with and without an electronic guidance system. Study design Four junior registrars performed their first 100 procedures on a training model with a new electronic guidance system, and four other junior registrars performed their first 100 procedures on the same training model without using the guidance system. All procedures were performed using a free-hand technique. We evaluated the quality of the procedure, which we defined as the time spent with the entire needle clearly visualized on the screen over the total duration of the procedure. We constructed learning curves fur the eight junior registrars for comparative analysis. Results Quality of the procedure increased over time for all trainees. The learning curves were significantly steeper for trainees using the electronic guidance system. Trainees using the electronic guidance system performed better in the middle of their learning curve (procedures 25-75). All trainees reached the same level of quality by the end of their 100 procedures. Conclusions The automated electronic guidance system helps faster learning but, after 100 procedures on a training Model, both groups reached the same level of quality.