To evaluate the efficacy of stepwise training with a diversified teaching mode in enhancing residents' clinical competency in early pregnancy ultrasound.

This study included 14 first-year residents undergoing standardized training in the ultrasound department at Peking Union Medical College Hospital. An advanced training program was implemented with three progressive modules: theoretical teaching, virtual simulation training, and clinical practice mentorship. The curriculum integrated diversified case-based learning approaches, including peer teaching for image interpretation, analysis of missed and misdiagnosed cases, and remote case consultations. A pre- and post-training Likert-scale questionnaire, designed via Questionnaire Star, was used to assess trainees' understanding of early pregnancy ultrasound. Training efficacy was measured by confidence self-ratings in early pregnancy ultrasound diagnosis and answer accuracy, with χ² tests used to analyze changes in confidence levels.

The majority of trainees (85.72%, 12/14) perceived early pregnancy ultrasound as moderately or highly difficult, with only 14.28% (2/14) rating it as low difficulty. The baseline confidence level of trainees in early pregnancy ultrasound diagnosis was generally low, with 42.86% (6/14) being moderately confident, 42.86% (6/14) slightly confident, and 14.28% (2/14) completely unconfident. All trainees acknowledged the importance of the training [35.72% (5/14) agreed, 64.28% (9/14) strongly agreed], with high participation willingness [42.86% (6/14) willing, 57.14% (8/14) very willing]. Post-training evaluation revealed that 92.86% (13/14) of trainees considered the training helpful for early pregnancy ultrasound diagnosis. The trainees' confidence in early pregnancy ultrasound diagnosis significantly improved, with the moderate-or-higher confidence rate increasing from 42.86% (6/14) to 78.57% (11/14, χ²=6.105, P=0.013). Additionally, 85.71% (12/14) of the trainees achieved an examination answer accuracy rate of 80% or higher. However, challenges remained in embryonic development evaluation, ectopic pregnancy diagnosis, and chorionicity determination for twins.

The stepwise curriculum with diversified teaching mode effectively enhanced residents' clinical competence in early pregnancy ultrasound.