Table 3 Instructors’ daily reflections

1. Learners reminded to watch out for signs of distress in the mother and allow her to rest

2. Introduction of a form to record ‘abnormal’ pocus findings during training for communication to the primary healthcare provider

3. Preferred order of teaching and skills acquisition in the 5 thematic areas noted to be:

 i. Overview and fetal number

 ii. Fetal presentation and lie

 iii. Placenta location

 iv. Fetal heart rate assessment

 v. Amniotic fluid assessment

4. Pre requisites for taking the OSCE assessment (at least 20 scans for each of the 5 thematic areas) was done during the training to encourage commitment and seriousness from the learners

5. Weak learners were identified and instructors would give them more attention and patience. Extra scanning sessions at the end of the day were also allocated to them

6. Learners encouraged to form small study groups to further enhance their knowledge

7. Instructors were encouraged to demonstrate the ultrasound skill first before letting the learners start scanning

8. Asking of questions and seeking clarifications was highly encouraged from the learners

9. Practical session on probe movements and image orientation on the screen added to help learners further grasp the concept

10. All learners encouraged to observe decorum and dress code in clinical areas during scanning sessions at the health facilities