MASTERING AND TEACHING ULTRASOUND (US)

As you become more proficient as a provider and trainer, continue to master your own US skills for dating and guidance during procedures. Where available, try to provide your trainees with US experience at multiple gestational ages. In addition to reviewing basic US principles from Chapter 3, encourage learners to take advantage of interactive online curriculum that may be available in your setting. If you have other staff members proctoring trainees, consider observing a trainee sonogram yourself to assess skill level. Resources include:

• Ultrasound Training Videos (UW Ob/Gyn)
• American Institute of Ultrasound Medicine
• Early Pregnancy Ultrasound Skills Evaluation (see Chapter 13)

HELPING TO PREPARE FOR TRANSITIONS TO PRACTICE

As trainees progress, explore how they might integrate this material into their future careers.

• Discuss pros and cons of service provision in a primary care vs. high-volume setting
• Reinforce stories and benefits to patients of being able to offer services in one’s own practice.
• Review how decisions are informed by the legislative environment (e.g. may be more cautious/conservative in states where care is highly restrictive and politicized).
• Point out areas where different practice styles exist (e.g. ultrasound may be routinely used in a training or high-volume setting, but may be used as-needed in a primary care setting).
• From styles they have been exposed to, encourage trainees to consider how they might develop their own style.
• Toward the last training day, consider completing all steps (counseling to recovery) in one room, to simulate a primary care practice experience.

Reinforce the expectation that the trainee will be able to provide multiple aspects of care by the end of their training.

BUILDING STAFF SUPPORT FOR TRAINING

When establishing a training program, it is invaluable to build and maintain staff support and involvement in the training process. The following strategies have been useful:

• Discuss how patients benefit from training (i.e. implications of improved access)
• Use appropriately timed values clarification workshops and staff surveys
• Help reinforce the value of staff contribution to training new abortion providers
• Encourage leadership by creating roles for particular staff to be involved with trainees, demonstrating counseling, ultrasound, recovery or discharge teaching
• Encourage staff to give feedback to trainees, directly or through a system for anonymous feedback
• Encourage periodic discussion of clinic flow issues, strategies, and patient care with your staff, including huddles, debriefs, and staff meetings
• Share cumulative results of the training program with staff