P18.03: Learning curve for the ultrasonographic diagnosis of deep endometriosis using an intensive training program

To assess if a structured off-line training program improves diagnostic performance of gynecologist in evaluation of patients with deep infiltrating endometriosis (DIE). A two week training program was conducted. One day was devoted to theoretical issues and guided off line analysis of 10 volumes of three dimensional (3D) ultrasound. In the following days 4 sessions of real-time sonographic examinations were performed in DIE Ultrasound unit. In between sessions, 5 sets, containing 25 3D volumes each, were analysed by the trainees. At the end of each set misinterpreted volumes were assessed with the trainer. Gold standard was considered presence or absence of DIE at surgery. Their results were evaluated by learning curve cumulative summation (LC-CUSUM) and the deviations of the level of trainees' performance at the control-stage CUSUM (standard CUSUM) for different locations of DIE. One trainer and 4 trainees (all Ob/Gyn postgraduated with at least 5 years of experience in ultrasonography in Ob/Gyn but with no experience in DIE sonographic exam) participated in the study. The trainees reached competence on average after 17 evaluations (range 21-14) for anterior lesions, after 39 evaluations (60-30) for rectosigmoid locations, after 25 evaluations (range 34-14) for forniceal lesions, after 44 evaluations (66-25) for utero-sacral lesions (USL), after 21 evaluations (43-14) for rectovaginal septum (RVS) lesions, respectively and kept the process under control with error levels of less than 4.5% until the end of the test. In table 1 the success rates are reported. A learning protocol based on a mix of off-line and live sessions with a duration of two weeks may shorten the time of training for the diagnosis of DIE. P18.03: Table 1.