Development and validation of simulation training for vaginal hysterectomy.

Overview

STUDY OBJECTIVE: To develop and validate an educational intervention based on vaginal hysterectomy (VH) simulation. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: Surgical skills simulation center. PATIENTS: Thirty residents in Obstetrics and Gynecology (11 PGY-2, 11 PGY-3, and 8 PGY-4). INTERVENTION: VH educational intervention that included a lecture, a video, and surgical skill simulation using a new inexpensive model. MEASUREMENTS AND MAIN RESULTS: The primary outcome was written test scores before and after the educational intervention, and the secondary outcome was self-rated confidence in performing VH. Baseline written scores were similar for all 3 training levels; however, baseline confidence scores were higher for PGY-3 and PGY-4 residents than for PGY-2 residents (p < .01). After the workshop, written test scores improved significantly for all trainees (median [range] improvement, 4 [3.5-5.0] points; p < .01). Mean (SD) improvement in confidence scores for PGY-4, PGY-3, and PGY-2 residents was 0 (0.5), 0.5 (0.8), and 1 (1.3), respectively, with improvement in confidence scores reaching significance only for PGY-2 residents (p < .02). All trainees expressed high satisfaction with the workshop. CONCLUSION: An educational intervention based on VH simulation is feasible and improves knowledge and confidence in junior residents with limited exposure to VH.