Does Transparency Really Help?: Amniocentesis Teaching With Clear and Opaque Gelatin Models [85]. (May 2015)

• Record Type: Journal Article
• Authors: Sienas, Laura Elizabeth; Kabacka, Julia; Ramirez, Francisco; Hammontree, William; Bair, Aaron; Tache, Veronique
• Is Part Of: Obstetrics and gynecology. Volume 125(2015)Supplement 1
• Publication Date: 2015-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000463076.11324.46
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: To assess whether visualizing a fluid pocket during amniocentesis training helps improve skills required for the procedure, including needle placement and aspiration. METHODS: We performed an observational study using two models; one allowed trainees to visualize a fluid-filled area in a "uterus, " whereas the other required an ultrasonogram for localization. We randomly divided 16 obstetrics–gynecology residents into two groups. After a brief didactic, one group practiced their technique with the clear model ("clear" group), whereas the other group practiced with the opaque model ("opaque" group). Residents were compared with regard to time to aspiration, number of attempts (removal of entire needle), needle reorientations (movement of needle within space), and movement of the needle while aspirating. RESULTS: Pretest knowledge and skills were similar in both groups. Understanding of key amniocentesis concepts improved greatly after simulation (55% compared with 85%, P <.001) as did confidence in performing such procedures ( P <.001). There was no significant difference in the aspiration time between the clear and opaque group (76.9 compared with 81.6 seconds, P =.8). The numbers of needle attempts and reorientations were not different between clear and opaque groups ( P =.6 and P =1, respectively). Interestingly, the opaque group showed more needle tip movements during aspiration, although this was not significant ( P =.2). CONCLUSION: In trying to teach a complex skill such as amniocentesis, "visualizing" a uterus does not appear to improve skills. Likely, "seeing" the uterus minimizes the need for ultrasound correlation, yet simulation didactics are effective at teaching rare skills to residents and help boost confidence in procedures.