Vaginal Hysterectomy Rates Before and After Implementation of a Multiple-Tier Intervention

Crouss, Tess; Sharma, Shefali; Smith, Devon; Hunter, Krystal; Perry, Robin; Lipetskaia, Lioudmila

doi:10.1097/aog.0000000000004318

Cited by 2 publications

(3 citation statements)

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“…This is consistent with prior research showing that adequately supervised surgical trainees do not cause more surgical complications. 20 Existing model‐based vaginal surgery training curricula improve learner satisfaction and increase the number of performed hysterectomies, 7 , 21 yet they are not widely implemented because they lack evidence of improved performance in real clinical scenarios.…”

Section: Discussionmentioning

confidence: 99%

“…Most program directors who did not have access to a standard training curriculum wished to have one implemented that would allow novice surgeons to practice basic surgical skills in simulation laboratories, where errors and directed feedback in a safe environment catalyze learning 5 . There is ample evidence that simulation improves students' basic skills, satisfaction, and confidence 6 while increasing the numbers of performed procedures 7 . However, existing surgical training models or curricula, with the exception of fundamentals of laparoscopic surgery 8 and related laparoscopic training models, 9 do not have level one evidence of skill transferability to the real operating room (OR) environment.…”

Section: Introductionmentioning

confidence: 99%

“… 5 There is ample evidence that simulation improves students' basic skills, satisfaction, and confidence 6 while increasing the numbers of performed procedures. 7 However, existing surgical training models or curricula, with the exception of fundamentals of laparoscopic surgery 8 and related laparoscopic training models, 9 do not have level one evidence of skill transferability to the real operating room (OR) environment. We hypothesized that procedure‐specific training modules consisting of didactic teaching, procedural training and independent practice on low fidelity simulation models could fill this gap.…”

Section: Introductionmentioning

confidence: 99%

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Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial

Geoffrion,

Koenig,

Cundiff

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionVaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present study was to investigate whether procedure‐specific simulation skills, versus usual training, result in improved operative competence.Material and methodsWe completed a randomized controlled trial of didactic and procedural training via low fidelity vaginal surgery models for anterior repair, posterior repair (PR), vaginal hysterectomy (VH), recruiting novice gynecology residents at three academic centers. We evaluated performance via global rating scale (GRS) in the real operating room and for corresponding procedures by attending surgeon blinded to group. Prespecified secondary outcomes included procedural steps knowledge, overall performance, satisfaction, self‐confidence and intraoperative parameters. A priori sample size estimated 50 residents (20% absolute difference in GRS score, 25% SD, 80% power, alpha 0.05). Clinicaltrials.gov: Registration no. NCT05887570.ResultsWe randomized 83 residents to intervention or control and 55 completed the trial (2011–23). Baseline characteristics were similar, except for more fourth‐year control residents. After adjustment of confounders (age, level, baseline knowledge), GRS scores showed significant differences overall (mean difference 8.2; 95% confidence interval [CI]: 0.2–16.1; p = 0.044) and for VH (mean difference 12.0; 95% CI: 1.8–22.3; p = 0.02). The intervention group had significantly higher procedural steps knowledge and self‐confidence for VH and/or PR (p < 0.05, adjusted analysis). Estimated blood loss, operative time and complications were similar between groups.ConclusionsCompared to usual training, procedure‐specific didactic and low fidelity simulation modules for vaginal surgery resulted in significant improvements in operative performance and several other skill parameters.

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Section: Discussionmentioning

confidence: 99%