title: Teaching invasive prenatal procedures: effectiveness of two simple simulators in training.
abstract: BACKGROUND
  Chorionic villus sampling (CVS) and amniocentesis are the major tools of invasive prenatal diagnosis. We studied the effectiveness of two simulators in training in invasive procedures.
  
  
  METHODS
  Two affordable and simple simulators were developed, modelling the maternal abdomen and the different tissue layers crossed by the needle. The trainees were evaluated before and after practical and theoretical training. A score evaluating five criteria for technical quality in performing a procedure safely was established. Initial score of 9 or 10 was excluded. The primary endpoint was improvement defined as the change between pre-test and post-test, expressed as a percentage of the pre-test.
  
  
  RESULTS
  A total of 54 residents and 63 specialists in obstetrics and gynaecology participated. Residents improved their scores in the practice of amniocentesis (80% [43-167]) and CVS (100% [29-150]), as well as specialists (100% [25-233] and 67% [33-122]). Specialists who earlier performed one CVS or more than five amniocentesis procedures had a lower increase during training than those who had performed fewer than five procedures (p < 0.01). Being inexperienced in CVS was associated with greater improvement (27% vs 56%, p = 0.003).
  
  
  CONCLUSIONS
  A simple simulator improves the ability of physicians to perform invasive procedures in particular when initial experience is low. © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP Antoine Béclère Hospital, Univ Paris-Sud, Clamart, France. anne-gael.cordier@abc.aphp.fr.
authors.forename: Anne-Gael
authors.initials: AG
authors.lastname: Cordier
authors.affiliation: Department of Obstetrics and Gynaecology, AP-HP, Bicêtre Hospital, Univ Paris-Sud, Kremlin Bicêtre, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Fuchs
authors.affiliation: Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP Antoine Béclère Hospital, Univ Paris-Sud, Clamart, France.|Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP, Louis Mourier Hospital, Colombes, France.
authors.forename: Mikael
authors.initials: M
authors.lastname: Tassin
authors.affiliation: Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP Antoine Béclère Hospital, Univ Paris-Sud, Clamart, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Saada
authors.affiliation: Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP Antoine Béclère Hospital, Univ Paris-Sud, Clamart, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Letourneau
authors.affiliation: Department of Cytogenetics, AP-HP, Antoine Béclère Hospital, Univ Paris-Sud, Clamart, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Brisset
authors.affiliation: Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP, Louis Mourier Hospital, Colombes, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Mandelbrot
authors.affiliation: CPDP Pontoise, Pontoise, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bidat
authors.affiliation: Department of Obstetrics and Gynaecology and Reproductive Medicine, AP-HP Antoine Béclère Hospital, Univ Paris-Sud, Clamart, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benachi
mesh_terms: D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy; D007396:Internship and Residency; D009774:Obstetrics / Q000193:education*; D011296:Prenatal Diagnosis; D000066908:Simulation Training / Q000379:methods*; D016216:Ultrasonography, Prenatal