Assessment of a Brief Standardized Obstetric Ultrasound Training Program for Individuals Without Prior Ultrasound Experience

Abstract

Obstetric volume sweep imaging (OB VSI) is a simple set of transducer movements guided by external body landmarks that can be taught to ultrasound-naive non-experts. This approach can increase access to ultrasound in rural/low-resources settings lacking trained sonographers. This study presents and evaluates a training program for OB VSI. Six trainees without previous formal ultrasound experience received a training program on the OB VSI protocol containing focused didactics and supervised live hands-on ultrasound scanning practice. Trainees then independently performed 194 OB VSI examinations on pregnancies >14 weeks with known prenatal ultrasound abnormalities. Images were reviewed by maternal-fetal medicine specialists for the primary outcome (protocol deviation rates) and secondary outcomes (examination quality and image quality). Protocol deviation was present in 25.8% of cases, but only 7.7% of these errors affected the diagnostic potential of the ultrasound. Error rate differences between trainees ranged from 8.6% to 53.8% ( P < 0.0001). Image quality was excellent or acceptable in 88.2%, and 96.4% had image quality capable of yielding a diagnostic interpretation. The frequency of protocol deviations decreased over time in the majority of trainees, demonstrating retention of training program over time. This brief OB VSI training program for ultrasound-naive non-experts yielded operators capable of producing high-quality images capable of diagnostic interpretation after 3 hours of training. This training program could be adapted for use by local community members in low-resource/rural settings to increase access to obstetric ultrasound.

Diagnosis of Pregnancy Complications Using Blind Ultrasound Sweeps Performed by Individuals Without Prior Formal Ultrasound Training

“…Ultrasound operators received training on the volume sweep imaging blind sweep protocol as described previously. 30 The training curriculum was delivered to each person individually as a one-time, stand-alone session performed over 3 hours and included a didactic portion (about 60 minutes) using a visual aid (Fig. 1) and a video aid (https://cdn-links.lww.com/permalink/ruq/a/ ruq_00_00_2022_09_15_toscano_usq-d-22-00088_ sdc2.mov) and supervised, instructional clinical scanning portion (about 120 minutes) using volunteer pregnant people.…”

No sonographer, no radiologist: Assessing accuracy of artificial intelligence on breast ultrasound volume sweep imaging scans

“…The sweeps are saved as video clips which are later interpreted by a specialist. VSI can be learned over the course of hours as opposed to the years of dedicated training often required for ultrasound specialists [ 16 , 17 ]. This approach has already been successfully piloted for lung, obstetric, right upper quadrant, and thyroid scanning [ 15 , 18 – 21 , 23 ].…”

“…Volume sweep imaging (VSI) is an imaging technique that circumvents the problem of a lack of trained sonographers via the use of a standardized imaging protocol based on sweeps of the ultrasound probe over a target region in relation to external body landmarks [ 15 ]. VSI can be learned in a few hours by individuals without prior ultrasound training making ultrasound image acquisition readily accessible [ 16 , 17 ]. VSI has been combined with teleultrasound with encouraging clinical results for lung, obstetric, thyroid, and right upper quadrant scanning indications in Peru [ 15 , 18 – 21 ].…”

Sustainable volume sweep imaging lung teleultrasound in Peru: Public health perspectives from a new frontier in expanding access to imaging

“…Imaging is acquired with the lung VSI ultrasound protocol ( Supplementary Figure S1 ). VSI is an imaging technique in which an individual with minimal prior ultrasound training performs a specialized scan protocol based on external body landmarks requiring neither significant technical skill or anatomical knowledge ( 30 , 31 ). The imaging protocol consists of a series of blind sweeps of the ultrasound probe over the thorax.…”