Laparoscopic Vascular Injury Simulation for Gynecology Residents

Abstract

BACKGROUND: Residents demonstrate deficiencies of knowledge and skills performing forceps-assisted vaginal delivery (FAVD) that varies by year.OBJECTIVE: To assess resident performance of FAVD and evaluate if FAVD performance can be improved with didactic instruction and simulation training.METHODS: Resident knowledge, skills and attitudes of FAVD was assessed with a written test, objective standardized assessment of technical skills (OSATS) in a simulation environment and survey. After participation in a FAVD curriculum that included lecture, PowerPoint materials, suggested readings, and simulation sessions, these measures were repeated. Data were analyzed with x 2 , analysis of variance, and Wilcoxon signed-rank tests. RESULTS: Thirty-four residents participated. In the pretest phase, marked deficiencies of FAVD knowledge and skills were evident. Written test performance was fair and improved modestly (49.9613.9% to 59.565.5% [P5.018]). Postgraduate year (PGY) did not predict performance on the written test (P5.29), however performance on OSATS varied by PGY (OSATS range PGY-1536.7%-PGY-4570.2%, P5.001). Residents exhibited fair baseline knowledge, but poor skills especially in the application of forceps and checking placement. Across all PGY groups, knowledge and skills on the OSATS (P5.001), overall performance (P5.005), and economy of time and motion (P,.001) improved after participation. The difference in performance in OSATS precurriculum and postcurriculum was 24.0% (P5.12). Residents reported improved understanding of indications (0.014), steps (P5.007), application (P5.007) and confidence (P5.010) of FAVD.BACKGROUND: To assess the effectiveness of a novel anatomic curriculum employing construction of a model of female pelvic anatomy for medical students.