Amniocentesis Learning Curve Using A Low-Cost Simulation Model To Teach Maternal-Fetal Medicine Fellows

ObjectiveTo describe the learning curve for amniocentesis among Maternal-Fetal Medicine (MFM) fellows using a low-cost simulation model in Mexico.MethodsFourteen first- and second-year MFM fellows with no previous experience in amniocentesis participated in this single-center prospective study from March to June of 2019. The study was approved by the Institutional Review Board at the Instituto Nacional de Perinatologia and written informed consent was obtained from all participants. After an introductory course based on a standardized technique for amniocentesis, each fellow performed this procedure using a low-cost simulation model; experienced operators supervised the procedures. Learning curves were then created using cumulative sum analysis. Thresholds for acceptable and unacceptable failure rates were defined as 10% and 25%, respectively.ResultsExperienced MFM specialists evaluated 3675 procedures. On average, MFM fellows performed 263 53 procedures. The mean number to achieve competence was 255 53. The overall failure rate among the trainees was 16%.ConclusionWe describe individual learning curves for amniocentesis among MFM fellows using a low-cost simulation model. This approach allows direct assessment of proficiency in amniocentesis before clinical practice.The implementation of a low-cost simulation model and cumulative sum analysis allows training and monitoring of individual learning curves for amniocentesis.