A four-step palpation and fetal heart auscultation training method and system with adjustable fetal position

Abstract

The present application relates to the technical field of teaching training, in particular to a four-step palpation and fetal heart auscultation training method and system with adjustable fetal position; the method of the present application involves basic training and advanced training; the basic training adjusts the fetal position in a fixed order, and the single step is qualified to be locked or unqualified to be reset; the operation process is standardized, the accumulated deviation of the position and posture is eliminated; the four-step palpation is step-by-step practical operation and instant error correction, which conforms to the clinical standard; the data of the fetal position adjustment, palpation and auscultation are quantified and weighted, the operation ability is scientifically evaluated, and the pain points of the lack of standardization and the unscientific evaluation in the traditional training are solved; the advanced training constructs a dynamic fetal position model based on the clinical labor data, simulates the progressive change of the fetal position in the labor, fills in the blank of the dynamic scene, adjusts the position and posture without pre-warning, disposes the error in stages, strengthens the dynamic judgment and emergency ability of the trainee, trains in different difficulty gradients, generates a node evaluation report, and realizes the ability advancement from the basic standardization to the clinical practice.

Description

Technical Field

[0001] This invention relates to the field of teaching and training technology, specifically to a four-step palpation and fetal heart auscultation training method and system with adjustable fetal position. Background Technology

[0002] The four-step palpation and fetal heart sound auscultation model is an abdominal palpation and auscultation model widely used in nursing and midwifery courses, as well as in prenatal education programs for pregnant women and their families. The four-step palpation and fetal heart sound auscultation technique involves the examiner using both hands to palpate the pregnant woman's abdomen in four steps to obtain crucial information about the fetus's size, position, posture, presenting part, and fetal heart rate and characteristics, thus providing an important method for assessing the fetus's health in utero.

[0003] Currently, most existing four-step palpation models are single-position four-step palpation models, which cannot be used to practice judging different fetal positions, thus hindering students' comprehensive mastery of fetal position judgment. Secondly, existing palpation training lacks step-by-step practical operation standards and real-time error correction mechanisms, making it difficult for trainees to accurately grasp the positioning logic and pressure requirements of key areas such as the fundus, fetal back, fetal limbs, and presenting part. Errors are prone to accumulate, making it difficult to ensure the standardization of practical operation. In addition, current training evaluation is mainly based on subjective judgment without quantitative data support, making it impossible to objectively assess the overall operation level and accurately identify weak links. Moreover, the training mode is monotonous, lacking difficulty gradients and progression mechanisms, failing to achieve the ability to advance from basic standardized operation to clinical practice, and failing to meet the needs of modern obstetrics for precise and practical training of professionals. Summary of the Invention

[0004] The purpose of this invention is to provide a four-step palpation and fetal heart auscultation training method and system with adjustable fetal position.

[0005] The technical solution of this invention is as follows: A four-step palpation and fetal heart rate auscultation training method with adjustable fetal position includes the following procedures: S1. In the fetal position adjustment training project, if the current adjustment action is qualified, the corresponding fetal model position is locked, and then the next adjustment action is executed; if any adjustment action is unqualified, after the adjustment error prompt, the fetal model is initialized to the original state, and the adjustment action is re-executed; when all adjustment actions are qualified, the final fetal model position is locked; the judgment conditions for the qualification or failure of the adjustment action are: the confirmed position corresponding to the adjustment action is within or outside the preset adjustment position range; the execution time of each adjustment action, the number of adjustment error prompts, the adjustment position error are obtained, and the fetal position adjustment training results are formed; the fetal position adjustment training project is to perform the corresponding adjustment actions in sequence according to the order of fetal translation, fetal horizontal rotation, fetal pitch rotation, and fetal spin on the simulated fetal model in the abdomen to realize the fetal position adjustment of the fetal model; S2. In the palpation operation training project, if the current palpation operation position is unqualified, the current palpation operation will be re-executed after a palpation error prompt. When all palpation operations are qualified, the palpation results are recorded. The criteria for judging whether the palpation operation position is qualified or unqualified are: the palpation operation position is within or outside the preset qualified palpation position range. The position error, palpation operation duration, number of palpation error prompts, palpation pressure error, and palpation result error of each palpation operation are obtained to form the palpation operation training results. The palpation operation training project involves performing palpation operations that touch the fundus of the uterus, and / or the fetal back, and / or the fetal limbs, and / or the presenting part according to the palpation instructions. Simulated abdominal compression is performed in each palpation operation. S3. In the fetal heart sound auscultation project, the fetal heart sound auscultation area error, fetal heart auscultation duration, auscultation pressure error, auscultation result error are obtained, and the fetal heart auscultation training results are formed; the fetal heart sound auscultation project involves touching the fetal heart sound auscultation area, performing fetal heart auscultation, and recording the fetal heart auscultation results. S4. Based on the results of fetal position adjustment training, palpation operation training, and fetal heart auscultation training, a comprehensive training evaluation result is obtained.

[0006] In S4, the comprehensive training assessment results include unsatisfactory, satisfactory, good, and excellent. If the comprehensive training assessment result is unsatisfactory, repeat the operations of S1, S2, S3, and S4 until satisfactory, good, or excellent is achieved. If any item in the fetal heart auscultation training result exceeds the corresponding allowable threshold, the comprehensive training assessment result is unsatisfactory.

[0007] In S4, the specific steps to obtain the comprehensive training evaluation result are as follows: based on the fetal position adjustment training result, palpation operation training result, and fetal heart auscultation training result, respectively, obtain the fetal position adjustment training score, palpation operation training score, and fetal heart auscultation training score; perform a weighted summation of the fetal position adjustment training score, palpation operation training score, and fetal heart auscultation training score to obtain the comprehensive training score; and match the corresponding training result level according to the comprehensive training score to obtain the comprehensive training evaluation result.

[0008] The method for obtaining the fetal position adjustment training score is as follows: the score is determined by classifying and deducting the time taken to perform the adjustment action, the number of adjustment error prompts, the deviation of the adjustment position error from its respective optimal value, and by providing step-by-step compensation based on the number of corrective errors after errors.

[0009] If the comprehensive training evaluation result is satisfactory, good, or excellent, advanced training will be implemented as follows: Based on the historical clinical full-term delivery labor data set, a mapping model of labor process nodes and dynamic changes in fetal position will be constructed. The labor process nodes, initial fetal position, progressive dynamic change rules, multi-skill linkage task nodes, difficulty level, and error tolerance threshold corresponding to this training will be preset. The fetal model will be adjusted to the preset initial fetal position and locked, and the labor process tasks will be displayed, including fetal position determination, fetal palpation, and fetal heart sound auscultation. According to the mapping model of dynamic changes in fetal position at labor process nodes and the progressive dynamic change rules of fetal position, the position of the fetal model will be gradually adjusted. Within the position change cycle of the fetal model corresponding to each labor process node, the corresponding labor process task will be completed, and the result judgment of the labor process task will be made. After all the preset labor process nodes have been completed, the training data of all labor process nodes will be summarized, an advanced training evaluation report will be generated, and the advanced training will be completed.

[0010] The rules for the gradual dynamic change of fetal position include the correspondence between the rate of translational descent of the fetal model along the longitudinal axis of the human body, the increment of the internal rotation angle of horizontal rotation, the change in flexion angle of pitch angle, and the fetal position deviation of spin angle, respectively, and the nodes of labor.

[0011] The specific steps for judging the results of the labor process are as follows: The collected real-time operation data is compared with the standard operation parameter set corresponding to the current labor stage and the real-time fetal position to determine whether the operation and judgment results meet the standards; if the operation and judgment results meet the standards, the training data for this labor stage is recorded, and the fetal model position adjustment for the next labor stage is initiated; if the operation and judgment results do not meet the standards, graded treatment is performed according to the error tolerance threshold until the operation and judgment results for the current labor stage meet the standards.

[0012] The training scores for each labor stage in the advanced training evaluation report are based on the basic score of the labor stage, the stability score of the stage operation, and the deduction for the stage error tolerance consumption.

[0013] A four-step palpation and fetal heart rate auscultation training system with adjustable fetal position, used to implement the aforementioned four-step palpation and fetal heart rate auscultation training method with adjustable fetal position, comprising: The simulated abdominal unit is a simulated abdominal cavity; the fetal model unit, suspended inside the simulated abdominal unit, is used to mimic the fetus and serves as the object for palpation and fetal heart sound auscultation; the whole fetal orientation adjustable unit is used to realize the positional changes of the fetal model unit; the multimodal monitoring unit, located on the inner wall of the simulated abdominal unit, is used to monitor and acquire pressure data, audio data, and image data of the simulated abdominal unit; the main controller, electrically connected to the whole fetal orientation adjustable unit and the multimodal monitoring unit, is used for data interaction and calculation; the human-computer interaction unit, including a touch screen and a broadcaster, is used to display the pressure data, audio data, and image data transmitted from the main controller, and is located on the side of the simulated abdominal unit.

[0014] The beneficial effects of this invention are as follows: This invention provides a four-step palpation and fetal heart auscultation training method with adjustable fetal position. In the basic training stage, the method first adjusts the fetal position step-by-step in a fixed sequence of fetal translation, horizontal rotation, pitch rotation, and spin. If a single step is successful, the position is locked; if unsuccessful, the position is reset and repeated. This standardizes the trainee's operation process, avoids cumulative deviations in position caused by multi-degree-of-freedom adjustments, and solidifies single-step operation standards. Next, palpation and pressure are performed step-by-step according to clinical four-step palpation standards. If a single step's positioning is unsuccessful, immediate correction is provided, ensuring trainees accurately master the positioning and pressure requirements of key areas such as the fundus and fetal back, aligning with clinical practice logic. Finally, by quantifying the operational data of each step of fetal position adjustment, palpation, and auscultation, a weighted comprehensive score is calculated and a grade is assigned, objectively reflecting the trainee's overall operational ability, identifying weaknesses, and addressing the pain points of insufficient standardization, unscientific evaluation, and limited scenarios in traditional training, thus laying a solid foundation for trainees' clinical practice. This invention provides a four-step palpation and fetal heart auscultation training method with adjustable fetal position. In the advanced training stage, a dynamic mapping model is constructed based on clinical full-term delivery data. This model presets multiple difficulty levels of labor stages and progressive fetal position change rules to simulate dynamic changes in fetal position at different stages of labor, filling the gap in traditional training that lacks dynamic clinical scenarios. Then, through unannounced fetal position adjustments and graded error handling, coupled with a dedicated image enhancement scheme to eliminate the haze caused by medical-grade silicone scattering, the method strengthens trainees' ability to judge dynamic fetal position and handle emergencies. Simultaneously, it adds difficulty gradients and environmental interference to adapt to different training needs. Finally, a detailed evaluation report is generated through node scoring and a total score, comprehensively quantifying the performance throughout the entire labor process. This effectively improves trainees' comprehensive judgment and practical skills in dynamic labor, achieving an advancement from basic standardization to clinical practice, and meeting the modern obstetrics' demand for precise and practical training of professionals. Detailed Implementation

[0015] To make the objectives, technical solutions, and advantages of the exemplary embodiments of this application clearer, the technical solutions in the exemplary embodiments of this application are described clearly and completely below. Obviously, the described exemplary embodiments are only some embodiments of this application, and not all embodiments.

[0016] This embodiment provides a four-step palpation and fetal heart auscultation training system with adjustable fetal position, which is used to realize a four-step palpation and fetal heart auscultation training method with adjustable fetal position. It includes: a simulated abdominal unit, a fetal model unit, a whole fetal position adjustable unit, a multimodal monitoring unit, a main controller, and a human-computer interaction unit.

[0017] The simulated abdominal unit is a simulated abdominal cavity in which a fetal model unit is suspended. The fetal model unit is connected to a whole-fetal orientation adjustable unit for adjusting the position of the fetal model unit. A multimodal monitoring unit is also provided on the inner wall of the simulated abdominal unit to monitor and acquire pressure data, audio data, and image data of the inner wall of the simulated abdominal unit. The signal output terminal is electrically connected to the main controller. The main controller is electrically connected to the whole-fetal orientation adjustable unit, the multimodal monitoring unit, and the human-machine interaction unit to realize centralized control and data interaction of the entire system.

[0018] The simulated abdominal unit serves as the external support and operating platform, comprising a one-piece simulated upper body model molded according to the anatomical structure of human obstetrics and gynecology examination standards. This simulated upper body model includes at least the breasts, xiphoid process, abdominal wall, pubic symphysis, and the upper third of both thighs. Further, the abdominal wall of the simulated abdominal unit is made of silicone rubber, which is soft, elastic, and tough. Medical-grade silicone is preferred, and its reflective effect closely matches the human abdominal cavity, better mimicking the real state of light propagation within the abdominal cavity. The inner circumferential edge of the abdominal wall and the bottom plane simulating the abdominal cavity are evenly distributed with LED light strips containing visual feedback modules. The control terminals of the LED light strips are electrically connected to the main controller, used to visually display the fetal model's position and location in silhouette form when illuminated.

[0019] The fetal model unit, suspended entirely within the simulated abdominal assembly and located in the central region of the simulated human abdominal cavity, serves as the subject for four-step palpation and fetal heart sound auscultation. It is integrally cast from medical-grade silicone, replicating the anatomical shape, weight, and surface feel of a full-term fetus. The fetal model unit consists of two relatively movable parts: the fetal head and the fetal torso. Damped movable joints are incorporated to simulate the fetus's flexion and extension postures. Within the cavity between the two shoulder blades on the back of the fetal model assembly, a miniature wireless Bluetooth speaker containing a fetal heart sound playback module is fixedly installed. The speaker's audio control terminal is wirelessly connected to the main controller, allowing it to move synchronously with the fetal position, realistically recreating the dynamic changes in the clinical fetal heart sound source with the fetal orientation.

[0020] The fully adjustable fetal orientation unit is used to adjust the position and orientation of the fetal model unit, enabling fetal translation, horizontal rotation, pitching and rotation, and spin, facilitating the simulation of the engagement, non-engagement, and partial engagement of the presenting part, as well as the orientation of the presenting part, covering the orientation simulation of all fetal orientations in clinical practice.

[0021] The fully adjustable fetal position unit supports mechanical connection with the handle. Trainees can control the fully adjustable fetal position unit by manipulating the handle's posture, thus enabling manual changes in the fetal model unit's position.

[0022] The fully adjustable fetal position unit also supports electrical connection with the main controller. The main controller can realize the electric control of the fully adjustable fetal position unit through preset electrical signals, so as to realize the automatic change of the fetal model unit's position.

[0023] The multimodal monitoring unit, located on the inner wall of the simulated abdominal unit, is used to monitor and acquire pressure data, audio data, and image data of the simulated abdominal unit. It includes a distributed flexible pressure sensor array, a stethoscope module, and an image acquisition module.

[0024] The distributed flexible pressure sensor array consists of matrix-arranged flexible thin-film pressure sensors, which are fully covered and fixed to the inner side of the abdominal wall of the simulated abdominal assembly, covering the entire abdominal palpation operation area. It is used to collect data on the position, pressure, depth, timing, and duration of the student's palpation in real time. Its signal output is electrically connected to the analog acquisition port of the main controller through a shielded cable. The main controller can transmit the data from the distributed flexible pressure sensor array to the human-machine interaction unit for display.

[0025] The auscultation module includes a matching medical simulation stethoscope, a positioning submodule, and a sound acquisition submodule. The positioning submodule is integrated inside the probe of the simulation stethoscope, and the positioning base station is fixed at the corner of the simulated abdominal cavity to collect the spatial position data of the stethoscope probe in real time. The sound acquisition submodule is integrated inside the stethoscope probe to collect the audio signal from the fetal heart sound playback module. The signal output terminals of both the positioning submodule and the sound acquisition submodule are electrically connected to the main controller, which can transmit the auscultation data to the human-computer interaction unit for data display.

[0026] The main controller is an embedded PLC controller. It has a built-in clinical fetal orientation reference parameter library, operation qualification judgment algorithm, and mechanism motion control algorithm. It is used for execution mechanism motion control, data acquisition and processing, operation qualification judgment, training process control and signal output.

[0027] The human-computer interaction unit uses an industrial-grade touch screen and broadcaster, which is installed on the side of the simulated abdominal unit via a wall-mounted bracket. It is bidirectionally electrically connected to the main controller via a shielded cable, and is used to realize functions such as training mode selection, training parameter configuration, real-time operation prompts, display of internal pressure data, audio data, and image data of the simulated abdominal unit, display of training results, and export of historical data.

[0028] This embodiment provides a four-step palpation and fetal heart auscultation training method with adjustable fetal position, including basic training and advanced training. Trainees can first master standardized operating procedures through basic training, and then improve their comprehensive ability in dynamic clinical scenarios through advanced training.

[0029] During the basic training process, trainees control the fetal position adjustable unit through a handle, thereby controlling the position of the fetal model. The specific steps are detailed below.

[0030] S1. In the fetal position adjustment training project, if the current adjustment action is qualified, the corresponding fetal model position is locked, and then the next adjustment action is executed; if any adjustment action is unqualified, after the adjustment error prompt, the fetal model is initialized to the original state, and the adjustment action is re-executed; when all adjustment actions are qualified, the final fetal model position is locked; the execution time of each adjustment action, the number of adjustment error prompts, the adjustment position error are obtained, and the fetal position adjustment training results are formed; the fetal position adjustment training project is to perform corresponding adjustment actions on the simulated fetal model in the abdomen in the order of fetal translation, fetal horizontal rotation, fetal pitch rotation, and fetal spin to realize the fetal position adjustment of the fetal model.

[0031] The system employs a step-by-step adjustment sequence of fetal translation, horizontal rotation, pitch rotation, and spin, with each step locking the position upon successful completion and resetting for repetition if unsuccessful. This control method standardizes the trainees' fetal position adjustment procedures, aligning them with the actual operational logic of clinical fetal position adjustment and preventing chaotic position adjustments caused by disordered operations. Furthermore, locking the successful position step by step effectively prevents subsequent adjustments from interfering with the established posture, eliminating cumulative positional deviations caused by multi-degree-of-freedom adjustments and ensuring the accuracy and stability of the simulated fetal position. Simultaneously, the mechanism of resetting and re-execution for unsuccessful attempts forces trainees to solidify single-step operational standards, preventing deviations from being implemented in subsequent steps, significantly improving the rigor and standardization of fetal position adjustment training, and ensuring trainees master accurate and standardized fetal position adjustment skills.

[0032] Firstly, in the fetal position adjustment training program, based on the target fetal position, trainees control the translation module, dual-axis linkage rotation module, and fetal body spin module in the fully adjustable fetal position unit through the handle. They perform the corresponding adjustment actions in sequence according to the order of fetal body translation, fetal body horizontal rotation, fetal body pitch rotation, and fetal body spin, thereby realizing the fetal position adjustment of the simulated fetal model in the abdomen. This can standardize the trainees' operation process for fetal position adjustment and avoid the confusion of position adjustment caused by disordered operation.

[0033] During fetal position adjustment, if the current adjustment is successful, the corresponding fetal model position is locked, and then the current adjustment is executed. This avoids positioning deviations caused by simultaneous multi-axis movements, ensuring the accuracy and stability of the simulated fetal position. The criteria for determining whether an adjustment is successful or unsuccessful are: the confirmed position corresponding to the adjustment is within or outside the preset adjustment position range.

[0034] Meanwhile, if any adjustment action is unqualified, such as the position of fetal translation, horizontal rotation, pitching rotation, or self-rotation being outside the corresponding range, the main controller will automatically initialize the fetal model to its original state (position) after receiving an adjustment error prompt, including but not limited to a red light on the human-computer interaction unit. The trainee can then re-execute the adjustment action, which can greatly improve the rigor and standardization of fetal position adjustment training and ensure that the trainee masters accurate and standardized fetal position adjustment skills.

[0035] Finally, once all adjustments are satisfactory, the final fetal model position is locked, and the palpation training in S2 is executed. Meanwhile, the main controller records the execution time of each adjustment in S1, the number of error messages, and the positional error, thus generating the trainee's fetal position adjustment training results.

[0036] S2. In the palpation operation training project, if the current palpation operation position is unqualified, the current palpation operation will be re-executed after a palpation error prompt. When all palpation operations are qualified, the palpation results will be recorded. The criteria for judging whether the palpation operation position is qualified or unqualified are: the palpation operation position is within or outside the preset qualified palpation position range. The position error, palpation operation duration, number of palpation error prompts, palpation pressure error, and palpation result error of each palpation operation are obtained to form the palpation operation training results. The palpation operation training project involves performing palpation operations that touch the fundus of the uterus, and / or the fetal back, and / or the fetal limbs, and / or the presenting part according to the palpation instructions. Simulated abdominal compression is performed in each palpation operation.

[0037] This training method employs a step-by-step approach to palpation and pressure, focusing on the fundus, fetal back, fetal limbs, and presenting part. It provides immediate feedback and re-execution for any incorrect positioning at a single step. This method strictly adheres to the standard operating procedures for the four-step palpation in clinical obstetrics. It systematically standardizes the trainees' palpation sequence and site location logic. Real-time error correction at each step prevents the accumulation of mistakes, ensuring trainees accurately grasp the key points of positioning and pressure requirements for each critical palpation site. This enhances the accuracy and standardization of palpation operations, making palpation training more aligned with clinical practice needs.

[0038] Once the fetal model of the target training position is locked, palpation training is performed. In the palpation training program, the trainee enters the simulated abdominal unit through a detector and performs palpation operations on the fundus, and / or the fetal back, and / or the fetal limbs, and / or the presenting part, according to the palpation instructions on the human-computer interaction unit and the visual information inside the simulated abdominal unit. After each palpation operation, the trainee inputs the palpation results on the human-computer interaction unit, which then transmits the palpation results to the main controller.

[0039] In the palpation operation training program, if the current palpation operation position is unqualified, the current palpation operation will be re-executed after a palpation error prompt, including but not limited to a red light on the human-computer interaction unit. The criteria for determining whether a palpation operation position is qualified or unqualified are: the palpation operation position is within or outside the preset qualified palpation position range.

[0040] During fundal palpation, the multimodal monitoring unit monitors and records the student's palpation location, pressure, and operation duration, and transmits these data to the human-machine interface unit and the main controller, respectively. Simultaneously, the student inputs the fundal height assessment result to the human-machine interface unit, which then transmits the fundal height assessment result and the number of palpation error prompts to the main controller.

[0041] When palpating the fetal back and limbs, the multimodal monitoring unit monitors and records the student's palpation position, pressure, and operation time, and transmits them to the human-machine interface unit and the main controller respectively. At the same time, the student inputs the fetal back orientation judgment result to the human-machine interface unit, and the human-machine interface unit transmits the fetal back orientation judgment result and the number of palpation error prompts to the main controller.

[0042] When the presenting part is touched, the multimodal monitoring unit monitors and records the trainee's palpation position, pressure, and operation time, and transmits them to the human-machine interface unit and the main controller respectively. At the same time, the trainee inputs the presenting part type (e.g., fetal head or fetal buttock) judgment result to the human-machine interface unit, and the human-machine interface unit transmits the presenting part type judgment result and the number of palpation error prompts to the main controller.

[0043] Once all palpation procedures are deemed satisfactory, the palpation results are recorded, and then the fetal heart sound auscultation training in S3 is performed. Simultaneously, the main controller records the positional error, palpation duration, number of palpation error prompts, palpation pressure error, and palpation result error for each palpation procedure in S2, thus forming the palpation procedure training results.

[0044] S3. In the fetal heart sound auscultation project, the error of the fetal heart sound auscultation area, the duration of fetal heart sound auscultation, the error of auscultation pressure, and the error of auscultation results are obtained, and the fetal heart sound auscultation training results are formed; the fetal heart sound auscultation project involves touching the fetal heart sound auscultation area, performing fetal heart sound auscultation, and recording the fetal heart sound auscultation results.

[0045] After completing the palpation procedure, the trainee enters the simulated abdominal unit through a probe. The multimodal monitoring unit monitors and records the trainee's probe location and duration, transmitting this data to the human-computer interaction unit and the main controller. Simultaneously, the trainee inputs the fetal heart rate auscultation results (i.e., fetal heart rate assessment results) to the human-computer interaction unit, which then transmits these results to the main controller. The main controller records the fetal heart sound auscultation area error, auscultation duration, auscultation pressure error, and auscultation result error for S3, thus generating the fetal heart auscultation training results.

[0046] S4. Based on the results of fetal position adjustment training, palpation operation training, and fetal heart auscultation training, a comprehensive training evaluation result is obtained.

[0047] The operations S1, S2, and S3 complete one training session for the target fetal position. To quantify the overall quality of the trainee's operation, this embodiment also evaluates the training process. By collecting parameters such as the operation time, deviations, and number of errors for each stage of fetal position adjustment, palpation, and fetal heart auscultation, sub-training results are generated and a comprehensive evaluation is conducted. This comprehensively, objectively, and quantitatively reflects the trainee's overall operational ability, identifies weaknesses, and improves the scientific rigor and relevance of the training evaluation. If the above position selection and pressing are performed multiple times, the error is taken as the average of the errors from all attempts.

[0048] The specific steps to obtain the comprehensive training assessment results are as follows: Based on the results of fetal position adjustment training, palpation operation training, and fetal heart rate auscultation training, respectively, obtain fetal position adjustment training scores, palpation operation training scores, and fetal heart rate auscultation training scores; perform a weighted summation of the fetal position adjustment training scores, palpation operation training scores, and fetal heart rate auscultation training scores to obtain the comprehensive training score; based on the comprehensive training score, match the corresponding training result level, including four levels: unsatisfactory, satisfactory, good, and excellent, to obtain the comprehensive training assessment result.

[0049] The method for obtaining the fetal position adjustment training score is as follows: Deductions are applied based on the execution time of the adjustment, the number of error prompts, and the deviation of the adjustment position error from the optimal value. A tiered compensation is then applied based on the number of successful corrections after an error. The fewer successful corrections after an error, the more compensation points are awarded. For example, if the deviation from the optimal value is ≤2 seconds, 5 points are deducted; if the deviation is ≤5 seconds, 10 points are deducted. The specific deduction values ​​can be set according to actual needs. Tiered compensation is applied based on the number of successful corrections after an error. For example, if the number of successful corrections after an error is 1 (meaning the adjustment is successful after only one attempt), 6 points are compensated; if the number of successful corrections after an error is 2, 4 points are compensated; and if the number of successful corrections after an error is greater than 2, 0 points are compensated. The specific bonus values ​​can be set according to actual needs. The fetal position adjustment training score acquisition method in this embodiment, compared with the traditional fixed weighting or linear deduction method, does not require the introduction of subjective weight coefficients. The deviation grading deduction is more in line with the graded standardization requirements of clinical fetal position adjustment for accuracy and duration. The step-by-step error correction compensation can effectively motivate trainees to actively correct operational deviations and strengthen the closed-loop training effect.

[0050] The methods for obtaining the palpation training score and the fetal heart rate auscultation training score are similar to those for obtaining the fetal position adjustment training score, and will not be repeated here to save space.

[0051] The overall training score is calculated using the following formula: , For comprehensive training scoring, , , These are scores for fetal position adjustment training, palpation skills training, and fetal heart rate auscultation training. , , These are the weightings for fetal position adjustment training, palpation training, and fetal heart rate auscultation training, respectively. An error correction attenuation factor is used to quantify a trainee's self-correction ability based on error prompts. An operational stability adaptation factor is used to quantify the consistency of trainees' operations and avoid false compliance such as "single pass, multiple fluctuations".

[0052] The scoring weights are obtained using the following formula: , The weighting is for the fetal position adjustment training score, or the palpation operation training score, or the fetal heart rate auscultation training score. for ,or ,or , This is a correction constant used to prevent a score from approaching 0 when the weight is 0, thus improving the rationality of the calculation.

[0053] The error correction attenuation factor is obtained by the following formula: , To train the total number of errors throughout the process, The total number of corrected passes after an error. This is the attenuation coefficient, used to balance the impact weights of errors and corrections.

[0054] The operational stability fit factor is obtained by the following formula: , For the first n Actual value of parameters for each (single) operation. This is the average of the parameters from all individual operations. This represents the total number of operations. The optimal value for the parameter is S. The closer S is to 1, the smaller the operational fluctuation and the better the stability.

[0055] If the overall training assessment result is unsatisfactory, repeat the S1, S2, S3, and S4 operations until the result is satisfactory, good, or excellent. In addition, if any item in the fetal heart auscultation training result is unsatisfactory, that is, if any item in the fetal heart auscultation training result exceeds the corresponding allowable threshold, that is, the error of the fetal heart sound auscultation area is greater than the corresponding allowable error threshold, or the fetal heart auscultation duration is greater than the corresponding allowable duration threshold, or the auscultation compression error is greater than the corresponding allowable error threshold, or the auscultation result error is greater than the corresponding allowable error threshold, then the overall training assessment result is unsatisfactory.

[0056] Furthermore, considering that the fetal position changes dynamically during labor and uterine contractions, midwives need to perform palpation, auscultation, judgment, and decision-making simultaneously during this dynamic process. These are precisely the gaps in existing teaching. To improve trainees' comprehensive abilities in clinical dynamic scenarios, this embodiment designs an advanced training program if the comprehensive training evaluation result is satisfactory, good, or excellent. During the advanced training, the main controller electrically controls the whole fetal position adjustable unit to control the position of the fetal model. The specific steps are detailed below.

[0057] S5. Based on the historical clinical full-term delivery labor data set, construct a dynamic change mapping (virtual) model of fetal position at labor nodes, preset the labor nodes, initial fetal position, progressive dynamic change rules, labor tasks, difficulty level, and error tolerance threshold corresponding to this training; the main controller adjusts the fetal model to the initial fetal position corresponding to the preset labor node and locks it, and transmits the labor task to the human-computer interaction unit for display.

[0058] The labor process node fetal position dynamic change mapping model is divided into three core labor stages: the latent phase of the first labor stage, the active phase of the first labor stage, and the second labor stage. Each stage corresponds to different rules for fetal position dynamic changes and labor tasks. In the latent phase of the first labor stage, the fetal model's translational descent rate is 2-3 mm / cycle, and the internal rotation angle increment is ≤5° / cycle, triggering only labor tasks such as fetal position assessment and fetal heart sound auscultation. In the active phase of the first labor stage, the fetal model's translational descent rate is 4-6 mm / cycle, the internal rotation angle increment is 5°-15° / cycle, and the fetal position deviation of the spin angle is ≤10° / cycle, triggering labor tasks such as assessing the degree of descent of the presenting part, predicting dynamic changes in fetal position, and auscultating fetal heart sounds. In the second labor stage, the fetal model's translational descent rate is 8-10 mm / cycle, and the internal rotation angle increment is 15°-30° / cycle, triggering labor tasks such as identifying abnormal fetal position, fetal palpation, and auscultating fetal heart sounds.

[0059] The aforementioned labor tasks include determining fetal position, palpating the fetal body, and auscultating fetal heart sounds.

[0060] The aforementioned rules for the gradual dynamic change of fetal position include the correspondence between the rate of translational descent of the fetal model along the longitudinal axis of the human body, the increment of the internal rotation angle of horizontal rotation, the change in flexion angle of pitch angle, and the fetal position shift of spin angle, respectively, and the nodes of labor.

[0061] For beginner difficulty, set the single-cycle operation time limit to be greater than or equal to the first time threshold (preferably 60s), and the corresponding error tolerance threshold to be the first number of times (preferably 3 times). Turn off unannounced pose adjustment and give the trainee a prompt before pose adjustment.

[0062] For intermediate difficulty, set the first time threshold (preferably 30s) ≤ single cycle operation time limit < first time threshold (preferably 60s), and the corresponding error tolerance threshold is the second value times (preferably 2 times), and enable unannounced pose adjustment.

[0063] For advanced difficulty, set the single-cycle operation time limit to ≤ the first time threshold (preferably 30s), the error tolerance threshold to the second numerical value (preferably 1 time), enable high-speed unannounced position adjustment, and superimpose clinical environmental interference items such as uterine contraction interference sounds and fetal heart sounds.

[0064] S6. The main controller adjusts the fetal model's position gradually without warning during the trainee's operation, according to the preset labor stage fetal position dynamic change mapping model and the progressive dynamic change rules of fetal position. Within the position change cycle of the fetal model corresponding to each labor stage, the trainee completes the corresponding labor task, and the main controller judges the result of the labor task.

[0065] The specific operation for judging the results of the labor process is as follows: The main controller compares the collected real-time operation data with the standard operation parameter set corresponding to the current labor process node and the real-time fetal position to obtain whether the operation and judgment results meet the standards; if the operation and judgment results meet the standards, the main controller records the training data of this labor process node and proceeds to the progressive adjustment of the fetal model position for the next labor process node; if the operation and judgment results do not meet the standards, graded treatment is performed according to the error tolerance threshold until the operation and judgment results of the current labor process node meet the standards.

[0066] The tiered handling procedure is as follows: If the error tolerance threshold is not exceeded, the main controller triggers an immediate error prompt, notifying the human-computer interaction unit to provide an error message, accurately marking the error item and deviation amount, maintaining the current fetal position, and allowing the trainee to re-perform the operation and judgment within the time limit. If successful, the trainee proceeds to the next labor stage. If the error tolerance threshold is exceeded, the main controller locks the current fetal position, triggers an emergency prompt for abnormal labor, and forces the trainee to complete the input of abnormal fetal position identification, abnormal cause analysis, and corresponding clinical treatment plan. After completion, the fetal position is restored to the initial position of the current labor stage, and the operation is repeated.

[0067] Considering that trainees will determine fetal position based on fetal images during advanced training, in order to improve the display quality of fetal images, avoid scattering and fogging caused by LED light strips hitting the medical-grade silicone, and improve image quality to ensure clear fetal outlines, this embodiment performs image enhancement processing on the fetal images received by the main controller to obtain enhanced fetal images, which are then transmitted to the human-computer interaction unit. The specific details of the image enhancement processing steps are as follows.

[0068] Step 1: Extract pixel-level parameters from the fetal image and perform reflection mask extraction to obtain the reflection mask region. This can be achieved using the following calculation formula: , , , These are the pixels in the fetal image. The red, green, and blue channel values, For pixels The average gray value is used to determine the reflective area of ​​the LED; the gray value of the reflective area is significantly higher than that of the normal area. Determine the threshold for the reflective area of ​​the LED. These are adaptive coefficients; This is a mask for the LED reflective area. 1 indicates that the pixel is an LED reflective area, and 0 indicates a non-reflective area. It accurately locates the LED reflective pixels on the circumferential edge of the inner side of the abdominal wall and the bottom plane of the abdominal cavity, avoiding misjudging normal fetal areas.

[0069] Step 2: Suppress grayscale in the reflective mask area while preserving tire details in non-reflective areas to obtain a reflective-suppressed tire image. This does not affect the normal tire area and avoids the loss of tire details caused by the one-size-fits-all approach of traditional dehazing methods. This can be achieved through the following calculation formula: When hour, ,when hour, , To suppress reflections in the fetal image, This is the reflection suppression coefficient.

[0070] Step 3: Perform contour gradient orientation enhancement on the reflection-suppressed tire image to obtain a contour-enhanced image. Contour gradient orientation enhancement is achieved through the following calculation formula: , To enhance the contour of the image, To suppress reflection in the tire carcass image, the gradient value of the tire carcass contour can be calculated using the Sobel operator, which extracts only the gradient of the tire carcass contour direction and does not extract the background gradient. The contour enhancement coefficient is an adaptive coefficient for the grayscale contrast of the tire body; the lower the contrast, the larger the enhancement coefficient. The contour validity factor is used to filter out spurious gradients from non-fetal contours. The formula is as follows: Values ​​range from 0 to 1, applicable only to the fetal body outline area. This achieves targeted enhancement; the contour gradient targeted enhancement designed in this embodiment only enhances the contour area of ​​the tire body, and does not enhance the non-contour area, thus avoiding the amplification of background noise, and at the same time filters out false contours through the effectiveness factor.

[0071] Step 4: Perform adaptive grayscale normalization on the contour-enhanced image to eliminate grayscale fluctuations caused by reflection suppression and contour enhancement, obtaining the fetal body enhanced image. The calculation formula is as follows: , The pixel grayscale values ​​of the enhanced image of the fetus.

[0072] S7. After all the preset labor process nodes have been executed, the main controller summarizes the training data of all labor process nodes, generates an advanced training evaluation report, and completes the advanced training.

[0073] The advanced training evaluation report includes training data for all stages of labor, training scores for each stage of labor, and the overall advanced training score.

[0074] The training score for labor milestones is based on the obtained data, and the calculation formula is as follows: , , , , For the first i Training and scoring of individual labor stages , , The first i The basic score for each production process node, the node operation stability score, and the node error tolerance consumption deduction score. For the first i The difficulty level of each stage of the production process varies; the higher the difficulty level, the greater the difficulty. ; for the first The operational compliance rate of each production process node, and the final compliance rate. If the standard is not met, ; For the first i The operational stability adaptation factor for each production node is used to quantify the consistency of operation of a single node and avoid false qualification when the node meets the standard but the operation fluctuates greatly. For the first i The actual number of error messages used at each labor stage does not include rework after emergency procedures; For the first i Each labor stage corresponds to an error tolerance threshold. The more error tolerance is used at a single stage, the more points are deducted, up to a maximum deduction of 10 points (when the number of errors reaches the tolerance threshold for that stage), reflecting the error control requirements at the stage level. If an emergency response is triggered at that stage, an additional 5 points are deducted (i.e., ).

[0075] The advanced training score is calculated using the following formula: , For the overall score of advanced training, This represents the total number of production stages. Deduct points for emergency response penalties, triggering one emergency response (any node exceeds the fault tolerance threshold of that node). Triggering emergency response 2 or more times: No emergency response was triggered. The more times it is triggered, the heavier the penalty, with a maximum deduction of 20 points.

[0076] This embodiment provides a four-step palpation and fetal heart auscultation training method with adjustable fetal position. In the basic training stage, the method first adjusts the fetal position step-by-step in a fixed sequence of fetal translation, horizontal rotation, pitch rotation, and spin. If a single step is successful, the position is locked; if unsuccessful, the position is reset and repeated. This standardizes the trainee's operation process, avoids cumulative deviations in position caused by multi-degree-of-freedom adjustments, and solidifies single-step operation standards. Next, palpation and pressure are performed step-by-step according to clinical four-step palpation standards. If a single step's positioning is unsuccessful, immediate correction is provided, ensuring trainees accurately master the positioning and pressure requirements of key areas such as the fundus and fetal back, aligning with clinical practice logic. Finally, by quantifying the operational data of each step of fetal position adjustment, palpation, and auscultation, a weighted comprehensive score is calculated and a grade is assigned. This objectively reflects the trainee's overall operational ability, identifies weaknesses, and addresses the pain points of insufficient standardization, unscientific evaluation, and limited scenarios in traditional training, laying a solid foundation for trainees' clinical practice.

[0077] This embodiment provides a four-step palpation and fetal heart auscultation training method with adjustable fetal position. In the advanced training stage, a dynamic mapping model is constructed based on clinical full-term delivery data. This model presets multiple difficulty levels of labor stages and progressive fetal position change rules to simulate dynamic changes in fetal position at different stages of labor, filling the gap in traditional training that lacks dynamic clinical scenarios. Then, through unannounced fetal position adjustments and graded error handling, coupled with a dedicated image enhancement scheme to eliminate the haze caused by medical-grade silicone scattering, the training enhances the trainee's ability to judge dynamic fetal position and handle emergencies. Simultaneously, difficulty gradients and environmental interference are added to adapt to different training needs. Finally, a detailed evaluation report is generated through node scoring and a total score, comprehensively quantifying the performance throughout the entire labor process. This effectively improves the trainee's comprehensive judgment and practical skills in dynamic labor, achieving an advancement from basic standardization to clinical practice, and meeting the modern obstetrics' demand for precise and practical training of professionals.

[0078] While exemplary embodiments of the invention have been described herein, many other variations or modifications conforming to the principles of the invention can be directly determined or derived from the disclosure of this invention without departing from its spirit and scope. Therefore, the scope of the invention should be understood and recognized to cover all such other variations or modifications.

Claims

1. A four-step palpation and fetal heart rate auscultation training method with adjustable fetal position, characterized in that, This includes the following operations: S1. In the fetal position adjustment training program, if the current adjustment action is qualified, the corresponding fetal model position is locked, and then the next adjustment action is executed; if any adjustment action is unqualified, after the adjustment error prompt, the fetal model is initialized to the original state, and the adjustment action is re-executed; when all adjustment actions are qualified, the final fetal model position is locked; the judgment conditions for whether the adjustment action is qualified or unqualified are: the confirmed position corresponding to the adjustment action is within or outside the preset adjustment position range; The execution time of each adjustment action, the number of adjustment error prompts, and the adjustment position error were obtained, which formed the training results for fetal position adjustment. The aforementioned fetal position adjustment training program involves performing corresponding adjustment actions sequentially on a simulated fetal model inside the abdomen, following the order of fetal translation, fetal horizontal rotation, fetal pitching rotation, and fetal spin, to achieve fetal position adjustment of the fetal model. S2. In the palpation operation training program, if the current palpation operation position is not qualified, the current palpation operation will be re-executed after the palpation error prompt is displayed. Once all palpation procedures are deemed satisfactory, the palpation results are recorded. The criteria for determining whether a palpation position is qualified or unqualified are as follows: the palpation position is within or outside the preset qualified palpation position range; The positional error, duration of each palpation operation, number of palpation error prompts, palpation pressure error, and palpation result error of each palpation operation were obtained to form the palpation operation training results. The palpation training program involves performing palpation operations on the fundus, / and fetal back, / and fetal limbs, / and presenting part according to the palpation instructions, and simulating abdominal compression in each palpation operation; S3. In the fetal heart sound auscultation project, the fetal heart sound auscultation area error, fetal heart auscultation duration, auscultation pressure error, auscultation result error were obtained, and the fetal heart sound auscultation training results were formed. The aforementioned fetal heart sound auscultation item involves touching the fetal heart sound auscultation area, performing fetal heart auscultation, and recording the fetal heart auscultation results; S4. Based on the results of fetal position adjustment training, palpation operation training, and fetal heart auscultation training, a comprehensive training evaluation result is obtained.

2. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 1, characterized in that, In S4, the comprehensive training evaluation results include unsatisfactory, satisfactory, good, and excellent. If the comprehensive training evaluation result is unsatisfactory, repeat the operations of S1, S2, S3, and S4 until satisfactory, good, or excellent is achieved. If any item in the fetal heart rate auscultation training results exceeds the corresponding allowable threshold, the overall training evaluation result will be deemed unsatisfactory.

3. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 1, characterized in that, In S4, the operation to obtain the comprehensive training evaluation result is as follows: Fetal position adjustment training score, palpation operation training score, and fetal heart rate auscultation training score were obtained based on the results of fetal position adjustment training, palpation operation training, and fetal heart rate auscultation training, respectively. The scores for fetal position adjustment training, palpation operation training, and fetal heart rate auscultation training are weighted and summed to obtain a comprehensive training score. Based on the comprehensive training score, the corresponding training result level is matched to obtain the comprehensive training evaluation result.

4. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 3, characterized in that, The method for obtaining the fetal position adjustment training score is as follows: the score is determined by classifying and deducting the time taken to perform the adjustment action, the number of adjustment error prompts, the deviation of the adjustment position error from its respective optimal value, and by providing step-by-step compensation based on the number of corrective errors after errors.

5. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 1, characterized in that, If the overall training assessment result is satisfactory, good, or excellent, then proceed with advanced training as follows: Based on historical clinical full-term delivery labor data, a mapping model of labor process nodes and dynamic changes in fetal position is constructed. The labor process nodes, initial fetal position, progressive dynamic change rules, multi-skill linkage task nodes, difficulty level, and error tolerance threshold corresponding to this training are preset. Adjust the fetal model to the preset initial fetal position and lock it, and display the labor process tasks, including fetal position determination, fetal body palpation, and fetal heart sound auscultation. According to the dynamic change mapping model of fetal position at each labor stage and the rules of progressive dynamic change of fetal position, the position of the fetal model is gradually adjusted; within the position change cycle of the fetal model corresponding to each labor stage, the corresponding labor task is completed and the result of the labor task is judged. Once all preset labor stages have been completed, the training data for all labor stages is aggregated, an advanced training evaluation report is generated, and the advanced training is completed.

6. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 5, characterized in that, The rules for the gradual dynamic change of fetal position include the correspondence between the rate of translational descent of the fetal model along the longitudinal axis of the human body, the increment of the internal rotation angle of horizontal rotation, the change in flexion angle of pitch angle, and the fetal position deviation of spin angle, respectively, and the nodes of labor.

7. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 5, characterized in that, The specific steps for judging the results of the labor process are as follows: The collected real-time operation data is compared with the standard operation parameter set corresponding to the current labor stage and the real-time fetal position to determine whether the operation and judgment results meet the standards; if the operation and judgment results meet the standards, the training data for this labor stage is recorded, and the fetal model position adjustment for the next labor stage is initiated; if the operation and judgment results do not meet the standards, graded treatment is performed according to the error tolerance threshold until the operation and judgment results for the current labor stage meet the standards.

8. The four-step palpation and fetal heart rate auscultation training method with adjustable fetal position according to claim 5, characterized in that, The training scores for each labor stage in the advanced training evaluation report are based on the basic score of the labor stage, the stability score of the stage operation, and the deduction for the stage error tolerance consumption.

9. A four-step palpation and fetal heart rate auscultation training system with adjustable fetal position, used to implement the four-step palpation and fetal heart rate auscultation training method with adjustable fetal position as described in claim 1, characterized in that, include: The simulated abdominal unit is a simulated abdominal cavity; The fetal model unit, suspended inside the simulated abdominal unit, is used to mimic the fetus and serves as the object for palpation and fetal heart sound auscultation. The whole fetal orientation adjustable unit is used to realize the positional changes of the fetal model unit; A multimodal monitoring unit is installed on the inner wall of the simulated abdominal unit to monitor and acquire pressure data, audio data, and image data of the simulated abdominal unit. The main controller is electrically connected to the full tire orientation adjustable unit and the multimodal monitoring unit for data interaction and calculation.

10. The four-step palpation and fetal heart rate auscultation training system with adjustable fetal position according to claim 9, characterized in that, It also includes a human-computer interaction unit, which displays the pressure data, audio data, and image data transmitted from the main controller. This unit includes a touch screen and a broadcaster, and is located next to the simulated abdominal unit.