A Multi-Modality Pelvic Anatomy Education Program for Ob/Gyn Residents [15O]

Abstract

INTRODUCTION: Understanding pelvic anatomy is essential to training as an ob/gyn. In most residency programs, residents learn anatomy through self-guided reading and direct experiences in the operating room, which can be limited by time constraints and patient safety concerns. The purpose of our study was to develop and assess a novel pelvic anatomic education program for residents. METHODS: We utilized three different learning modalities: cadaveric dissection on unused cadavers from our medical school’s anatomy course, clay models of the pelvic floor, and didactic lectures. The cadaver dissection was presented in a “mock surgery” format. Learning objectives and relevant procedures were established for each year of training: abdominal wall anatomy and cesarean section for first years, pelvic spaces and abdominal hysterectomy for second years, presacral space and sacrocolpopexy for third years, and pelvic neuroanatomy for fourth years. Participants completed before and after multiple choice tests and a qualitative survey. RESULTS: 16 residents from all 4 years of training were recruited to participate in the program. The average pre-test score was 45% and average post-test score was 50%, (p=0.22). The majority of participants strongly agreed that the program was interesting (67%), enhanced their understanding of pelvic anatomy (73%), and increased their confidence in the operating room (53%). CONCLUSION: Our multi-modality pelvic anatomy program improved residents’ anatomic knowledge (although this was not statistically significant) and was well received as a clinically applicable educational activity. The cadaveric lab mirrored the gynecological surgical curriculum of our residency and was cost efficient through collaboration with the anatomy department.

Surgical education in urogynecology from low fidelity to virtual reality: Systematic review

“…Eighteen articles were abstracts, and 22 were manuscripts of which six were videos demonstrating or describing the construction of the models. Five articles reported under the category of multimodal workshops also used static models 14,15,56–58 . The models ranged from low to high fidelity.…”

“…One article was reported under both “animals” and “cadavers” since it included both interventions 44 . Four articles reported under the category of multimodal workshops also used cadavers 15,56–58 . The procedures taught with cadaver training included midurethral slings (e.g., transobturator, tension‐free vaginal tape), artificial urethral sphincter, sacrospinous ligament fixation, uterosacral ligament suspension, laparoscopic sacrocolpopexy, and pelvic mesh surgeries.…”

“…44 Four articles reported under the category of multimodal workshops also used cadavers. 15,[56][57][58] The procedures taught with cadaver training included midurethral slings (e.g., transobturator, tension-free vaginal tape), artificial urethral sphincter, sacrospinous ligament fixation, uterosacral ligament suspension, laparoscopic sacrocolpopexy, and pelvic mesh surgeries. Subjective outcomes were described in seven articles with the most common being confidence (n = 4) followed by usefulness (n = 3) and satisfaction (n = 3) with cadaver models; other outcomes included comfort level (n = 1), realism (n = 1), and self-reported knowledge (n = 1).…”

“…Five articles reported under the category of multimodal workshops also used static models. 14,15,[56][57][58] The models ranged from low to high fidelity. The procedures taught with static models included transabdominal pelvic organ prolapse surgery (e.g., laparoscopic, robotic-assisted sacrocolpopexy), transvaginal surgery (e.g., total vaginal hysterectomy), native tissue apical prolapse suspension site-specific repairs (e.g., colpectomy and colpoclesis), cystoscopy, advanced laparoscopy (e.g., ex-retroperitoneal dissection), and anti-incontinence procedures (e.g., laparoscopic Burch Colposuspension, transobturator, and retropubic midurethral slings).…”

Evaluation of a Structured Female Pelvic Medicine and Reconstructive Surgery Resident Rotation Curriculum

“…[3][4][5][6] Structured curriculum studies have also been completed for specific knowledge areas that are not always incorporated into core rotations, such as genetics in pediatric residency, menopause in obstetrics and gy necology residency, or conducting research. [7][8][9][10][11] There are no current studies that show the self-reported impact of a structured curriculum on content comprehension in a surgical subspecialty residency rotation.…”