A Hysteroscopy Simulation Program for Intern Safety [27B]

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Abstract

INTRODUCTION:

Hysteroscopy is a fundamental gynecologic skill that allows direct visualization of the uterine cavity. Many residency programs have incorporated simulation activities into their training. The objective of this study was to determine if a simulation program using a virtual reality resectoscope would improve medical knowledge, surgical skill, and confidence of residents performing a hysteroscopy.

METHODS:

A pre-posttest model was used to assess the effectiveness of implementing a simulation curriculum into obstetrics and gynecology residency training. The primary components of the curriculum included didactic review, demonstration and practice using a hysteroscopy simulator. Outcomes were measured comparing knowledge test scores, performance assessments using a validated scoring system (percent of pathology removed, safety, economy, visualization, and fluid handling) and subjective surveys to assess comfort and confidence with hysteroscopic procedures.

RESULTS:

Six interns participated in the simulation program. The mean knowledge exam score improved 37.9 percentage points (95% CI 21.2–54.6, P<.01), the average overall simulator score improved 28.3 percentage points (95% CI 13.9–42.8, P<.01), and the percentage of simulator categories that each individual completed at goal improved 26.5 percentage points (95% CI 13.6–39.5, P<.01). The subjective surveys indicated a significant improvement in confidence with hysteroscopy from 1.8 to 4.1 on a 5-point Likert scale (95% CI 1.6–3.1, P<.01).

CONCLUSION:

Trainees experienced statistically significant improvements in knowledge, surgical skill assessments, and subjective confidence related to hysteroscopic procedures. Implementing a formal simulation curriculum to novice residents yields rapid improvements to hone skills in a less pressured environment in order to safely operate on future patients.

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