Educational strategies in prenatal anomaly scanning: teaching, simulation and competence assessment

INTRODUCTION: Prenatal anomaly scanning is a core component of obstetric care, yet remains highly operator-dependent. Variability in training contributes to inconsistent detection rates of fetal anomalies. Structured, multimodal educational strategies have been proposed to improve competence across undergraduate and postgraduate learners. This review synthesizes evidence on teaching methods, simulation modalities, digital learning tools, and assessment frameworks for anomaly scan education. METHODS: A comprehensive narrative review of the literature without language or time restrictions was performed, integrating data on traditional teaching, simulation-based training, e-learning, artificial intelligence (AI) tools, and competence assessment methodologies. Evidence from undergraduate, residency, and fellowship training contexts was evaluated, with attention to skill acquisition, transfer to clinical practice, and programmatic implementation. RESULTS: Traditional apprenticeship, didactic instruction, peer learning, and case-based teaching provide foundational knowledge but insufficient psychomotor skill acquisition when used alone. Simulation-based training-high-fidelity mannequins, VR/AR systems, and hybrid phantoms-significantly accelerates learners' ability to obtain standard fetal views and diagnose anomalies, with documented transfer to real-patient performance. Digital tools, including e-learning modules, app-based simulators, and emerging AI-driven feedback systems, further support standardized and scalable training. Assessment strategies such as OSCEs, OSAUS global rating scales, logbooks, and image-quality benchmarks enable structured and objective evaluation, although no universal standard yet exists. DISCUSSION: Blended learning approaches that combine cognitive, psychomotor, and reflective modalities offer the most reliable educational outcomes. Simulation and AI-supported systems may mitigate resource limitations and enhance training consistency. Remaining challenges include cost, faculty development, and curriculum standardization.