IPHONE AND IPAD TECHNOLOGY AS A QUANTITATIVE
METHOD FOR MEASURING AND DOCUMENTING CLINICAL
COMPETENCY IN ULTRASOUNDRobert
TEACHING.
K. Sigman, M.D.
John R. MacMillan Rodney, M.D
Maternal Child Health Fellow
Department of Family Medicine
Affiliate University of Texas, Southwestern
John Peter Smith Hospital
Fort Worth, Texas
Kelly R. Arnold, M.D
Assistant Professor, Family Medicine
University of Tennessee
Chattanooga, TN
Division of Maternal Fetal Medicine
Department of Obstetrics and Gynecology
University of North Texas
Health Sciences Center
Fort Worth, Texas
Wm. MacMillan Rodney
Director, Surgical Family Medicine Obstetrics
Medicos para la Familia Fellowship
Memphis, TN
Disclosure
• Neither I nor my partners have any
relevant financial interests,
arrangements, or affiliations with a
commercial interest.
Global Use of OB-GYN Ultrasound
• Basic ultrasound competency is
necessary for the practice of
obstetrics and gynecology in any
setting.
• These settings range from
primary care clinics to tertiary
subspecialty settings.
– Family Medicine Clinics
– Labor and Delivery
– Maternal Fetal Medicine
– Rural, Remote, Underserved
Areas
Global Need to Assess and Establish
Competency
• As technology has
improved, ultrasound has
become more portable
and available.
• As a result, bedside and
outpatient sonography
are increasingly common.
• Yet there are no easily
established methods to
assess, research, and
establish competency.
Application Development
• To facilitate appropriate
documentation
• To verify structural
identification
• To validate common
measurements
• To quantify competency
• To permanently store
faculty sign off on
resident reports
iPhone and iPad Interfaces
Camera Function:
How are the images obtained and processed?
• Using camera
function built into
iPhone and iPad
• Accessing native files
from the camera roll
• These files can be
cropped, rotated,
and transmitted to
this app.
Camera Function:
How are the images obtained and processed?
Camera Function Examples:
5 Common Biometric Markers
• Crown Rump Length
• Biparietal Diameter
• Head Circumference
• Abdominal Circumference
• Femur Length
1st Trimester Crown Rump Length
2nd Trimester Biparietal Diameter
2nd Trimester Head Circumference
2nd Trimester Abdominal
Circumference
2nd Trimester Femur Length
Student 2nd/3rd Trimester Report
Final Documentation By Student
Faculty Edit Student 2nd/3rd Tri Report
Faculty Sign Off
• “The student
has fulfilled
documentation
of competencies
or deficiencies
for the following
areas.”
Competent
Crown Rump Length
Biparietal Diameter
Head Circumference
Abdominal Circumference
Femur Length
Deficient
This program is NOT designed to:
• Replace existing ultrasound reporting
programs.
• Generate a billing matrix.
• Replace AIUM criteria for various
levels of examinations.
This program IS designed to show:
• The resident’s educational progress in
response to a curriculum.
• The resident’s limitations and deficiencies as
they progress through training.
• The resident’s knowledge that she has not
completed the entire program until signed off
by faculty.
• The faculty’s permanent documented
confidence in the student’s ability.
Future Applications
• The initial app was constructed for the most
basic competency.
• It does not preclude more advanced teaching
by the ultrasound program in the future.
• Cine-looping and organogenesis surveys are
currently in development.
Acknowledgements
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Dr. Robert K. Sigman, Maternal Fetal Medicine, Senior Presenter
Department of Family Medicine at JPS
Department of Obstetrics and Gynecology JPS
Department of Academic Affairs at JPS
Dr. Kelly Arnold, Assistant Professor, University of Tennessee, Chattanooga
Dr. Patricia S. Poole, Radiology Resident University of California, San Diego
Dr. Wm Rodney, Director Obstetrics Fellowship, Medicos para la Familia
Dr. John O. Gibson, Director Global Health Fellowship, JPS
Dr. David E. McRay, Director Maternal Child Health Fellowship, JPS
Dr. Daniel Casey, Program Director Family Medicine, JPS
Dr. Joane Baumer, Chairman Family Medicine, JPS
Dr. David Moreland, Program Director Obstetrics and Gynecology, JPS
Dr. G. Sealy Massingill, Chairman Obstetrics and Gynecology, JPS
Dr. Elwyn Grimes, Former Chair Obstetrics and Gynecology, JPS
QUESTIONS?