Impact of accreditation training for residents on sonographic quality in gynecologic emergencies.
OBJECTIVE
To assess the impact of an educational intervention based on an original accreditation training program on the quality of emergency sonography performed by obstetrics and gynecology (Ob/Gyn) residents.


METHODS
We conducted a prospective before-after study on residents who performed bedside standardized sonographic examinations as first-line investigations in patients seen at our gynecologic emergency department. In both periods, the residents followed a 1-hour class taught by a board-certified Ob/Gyn sonography expert (opinion leader) and received a written standardized imaging protocol. An accreditation training process was implemented for the new residents at the beginning of the second period: 5 complete sonographic examinations were required for each resident, and facilitated feedback from the opinion leader was performed using a dedicated sonographic quality score. During both periods, all consecutive sonograms were collected and stored. The primary outcome was the sonographic quality score. A mixed model for repeated measures was used to compare scores in both periods from 20 consecutive sonographic examinations performed by 5 residents who were different in each period.


RESULTS
The mixed model analysis showed an increase in quality scores in the post-accreditation training compared to the pre-accreditation training period (estimated coefficient ± SD, 4.13 ± 0.51; t = 8.16). The sonographic examination order also had a significant effect in both periods (estimated coefficient ± SD, 0.11 ± 0.03; t = 3.99).


CONCLUSIONS
An accreditation training process including facilitated feedback from a local opinion leader improved the quality of sonographic examinations performed by Ob/Gyn residents in women presenting to a gynecologic emergency department.
Department of Obstetrics, Gynecology, and Reproductive Medicine, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France (T.P., C.H., K.F., A.F.); University Versailles Saint-Quentin-en-Yvelines, Versailles, France (T.P., C.H., K.F., A.F.); Research Unit EA 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles Saint-Quentin, Montigny-le-Bretonneux, France (T.P., C.H., A.D., A.F.); Institut National de la Santé et de la Recherche Médicale Unité 669, University Paris-Sud and University Paris-Descartes, Paris, France (B.F.); and Unité Mixte de Recherche 216, Institut de Recherche Pour le Développement Paris Descartes, Université Paris Descartes, Paris, France (A.D.).
Thomas
T
Popowski
Department of Obstetrics, Gynecology, and Reproductive Medicine, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France (T.P., C.H., K.F., A.F.); University Versailles Saint-Quentin-en-Yvelines, Versailles, France (T.P., C.H., K.F., A.F.); Research Unit EA 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles Saint-Quentin, Montigny-le-Bretonneux, France (T.P., C.H., A.D., A.F.); Institut National de la Santé et de la Recherche Médicale Unité 669, University Paris-Sud and University Paris-Descartes, Paris, France (B.F.); and Unité Mixte de Recherche 216, Institut de Recherche Pour le Développement Paris Descartes, Université Paris Descartes, Paris, France (A.D.).
Cyrille
C
Huchon
Department of Obstetrics, Gynecology, and Reproductive Medicine, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France (T.P., C.H., K.F., A.F.); University Versailles Saint-Quentin-en-Yvelines, Versailles, France (T.P., C.H., K.F., A.F.); Research Unit EA 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles Saint-Quentin, Montigny-le-Bretonneux, France (T.P., C.H., A.D., A.F.); Institut National de la Santé et de la Recherche Médicale Unité 669, University Paris-Sud and University Paris-Descartes, Paris, France (B.F.); and Unité Mixte de Recherche 216, Institut de Recherche Pour le Développement Paris Descartes, Université Paris Descartes, Paris, France (A.D.).
Khadija
K
Fathallah
Department of Obstetrics, Gynecology, and Reproductive Medicine, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France (T.P., C.H., K.F., A.F.); University Versailles Saint-Quentin-en-Yvelines, Versailles, France (T.P., C.H., K.F., A.F.); Research Unit EA 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles Saint-Quentin, Montigny-le-Bretonneux, France (T.P., C.H., A.D., A.F.); Institut National de la Santé et de la Recherche Médicale Unité 669, University Paris-Sud and University Paris-Descartes, Paris, France (B.F.); and Unité Mixte de Recherche 216, Institut de Recherche Pour le Développement Paris Descartes, Université Paris Descartes, Paris, France (A.D.).
Bruno
B
Falissard
Department of Obstetrics, Gynecology, and Reproductive Medicine, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France (T.P., C.H., K.F., A.F.); University Versailles Saint-Quentin-en-Yvelines, Versailles, France (T.P., C.H., K.F., A.F.); Research Unit EA 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles Saint-Quentin, Montigny-le-Bretonneux, France (T.P., C.H., A.D., A.F.); Institut National de la Santé et de la Recherche Médicale Unité 669, University Paris-Sud and University Paris-Descartes, Paris, France (B.F.); and Unité Mixte de Recherche 216, Institut de Recherche Pour le Développement Paris Descartes, Université Paris Descartes, Paris, France (A.D.).
Alexandre
A
Dumont
Department of Obstetrics, Gynecology, and Reproductive Medicine, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France (T.P., C.H., K.F., A.F.); University Versailles Saint-Quentin-en-Yvelines, Versailles, France (T.P., C.H., K.F., A.F.); Research Unit EA 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles Saint-Quentin, Montigny-le-Bretonneux, France (T.P., C.H., A.D., A.F.); Institut National de la Santé et de la Recherche Médicale Unité 669, University Paris-Sud and University Paris-Descartes, Paris, France (B.F.); and Unité Mixte de Recherche 216, Institut de Recherche Pour le Développement Paris Descartes, Université Paris Descartes, Paris, France (A.D.) afauconnier@chi-poissy-st-germain.fr.
Arnaud
A
Fauconnier
D000068:Accreditation / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006176:Gynecology / Q000193:education; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D009774:Obstetrics / Q000193:education; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011871:Radiology / Q000193:education*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography
accreditation; gynecologic emergency; residency training; sonography; ultrasound education