title: Implementation of transvaginal ultrasound in an emergency department residency program: an analysis of resident interpretation.
abstract: BACKGROUND
  Emergency physicians are increasingly performing transvaginal ultrasound (TVUS) to rule out ectopic pregnancy. However, little is known about appropriate educational pathways to train emergency medicine residents in TVUS.
  
  
  OBJECTIVE
  To evaluate the ability of Emergency Medicine (EM) residents who underwent a training program in TVUS to detect the presence or absence of an intrauterine pregnancy (IUP) in patients of < 13 weeks gestation with vaginal bleeding or abdominal pain, as compared to the final interpretation of each study as determined by the Emergency Department (ED) Director of Ultrasound.
  
  
  METHODS
  This was a prospective, observational study in a single residency program. Training included a lecture, competency examination, and 10 supervised TVUSs. The EM residents then performed TVUSs with the goal of determining the presence or absence of an IUP without input from an attending physician. Correlation with the ED Director of Ultrasound was assessed for the cohort, and stratified by year of training.
  
  
  RESULTS
  There were 22 residents who performed 75 TVUSs over 17 months. Correlation with the ED Director of Ultrasound was 93.3%. Differences in correlation with the ED Director of Ultrasound were noted when compared by year of training: post-graduate year (PGY)-3 (93.3%), PGY-2 (92.1%), and PGY-1 (100%); p < 0.001.
  
  
  CONCLUSIONS
  Residents were able to perform TVUSs to determine the presence or absence of an IUP in patients in whom the diagnosis of ectopic pregnancy was being considered with a high degree of correlation with the ED Director of Ultrasound after a brief training program. Correlation with the ED director of ultrasound was influenced by year of training.
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA.
authors.forename: Casey Z
authors.initials: CZ
authors.lastname: MacVane
authors.forename: Christine B
authors.initials: CB
authors.lastname: Irish
authors.forename: Tania D
authors.initials: TD
authors.lastname: Strout
authors.forename: William B
authors.initials: WB
authors.lastname: Owens
mesh_terms: D002983:Clinical Competence; D003937:Diagnosis, Differential; D004635:Emergency Medicine / Q000193:education*; D019160:Endosonography; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000209:etiology; D014621:Vagina