Delivering unexpected news via obstetric ultrasound: A systematic review and meta‐ethnographic synthesis of expectant parent and staff experiences

Expectant parents report negative experiences of receiving unexpected news via ultrasound. There is a need to improve communication in this setting, but a lack of understanding on how to achieve this. This systematic review aimed to synthesise findings from qualitative studies exploring experiences of expectant parents or healthcare professionals when a fetal abnormality or unexpected finding was identified via ultrasound. MEDLINE, EMBASE, CINAHL and PsycINFO were searched using three blocks of terms (fetal abnormalities; ultrasound; experiences). Qualitative studies exploring the disclosure of pregnancy complications during ultrasound examinations were included and analysed using meta‐ethnographic synthesis. The review was conducted according to PRISMA and eMERGe guidelines. The review identified 28 studies. News delivered via ultrasound can be viewed as a journey involving five phases (expectations of ultrasound scans; discovery; shock; decisions and planning; adaptation). How well this is navigated depends upon the extent to which information needs and support needs are met. Ultrasound is a uniquely challenging situation to communicate difficult news as there is the potential for news to be communicated immediately. Care quality could be improved by the provision of written information and the use of correct terminology to describe abnormalities

Simulation in Obstetrics and Gynecology

Simulation training in obstetrics and gynecology has been used for hundreds of years. The apprenticeship model of training has evolved to include group simulations and virtual reality trainers. The American Congress of Obstetricians and Gynecologists (ACOG) and other professional societies have recognized the importance of simulation and formulated recommendations and/or curricula for appropriate training of residents, fellows, students, and staff. Obstetrics has utilized simulation mannequins to teach the birthing process and is taking advantage of simulation and the associated debriefing sessions for training in emergency and uncommon scenarios as well as in multidisciplinary training. Gynecology has used box trainers and virtual reality simulation to improve procedural skills of trainees outside the operating room using proficiency-based training paradigms. Simulation has also allowed for improvements in the objectivity of assessments. Future directions may include crowdsourcing for the evaluation of surgical proficiency and possibly for credentialing purposes