Nancy Gaba, MDPURPOSE:
To improve confidence and competence of residents in performing abdominal hysterectomy.BACKGROUND:
Our institution has a decreasing number of abdominal hysterectomies. Total cases logged by chiefs decreased from 216 in 2013 to 111 in 2016 graduating chiefs.METHODS:
After obtaining IRB exemption, a 3-D printer was used to produce a model to teach abdominal hysterectomy. The residents were given a pre-test consisting of a Likert scale survey to assess their confidence with the procedure as well as a knowledge assessment. They then underwent the intervention/simulation which included anatomy, instrument identification and procedural steps. The same Likert scale survey and knowledge assessment were given post-intervention. The dependent t-test was used to compare mean knowledge scores. Likert scale questions were dichotomized and compared using a two sample test of proportions.RESULTS:
We have a small residency program and had a total of eleven residents participating in this study. When broken down by level of training, overall knowledge scores increased by all levels of training, however they were only statistically significant for the third year residents. When broken down into individual categories, instruments/anatomy/incision types/procedural steps, the percent correct increased on all topics. This was statistically significant for anatomy, incision types and procedural steps. When looking at the resident comfort performing abdominal hysterectomy, residents were more comfortable after the simulation.DISCUSSION:
Implementation of this new abdominal hysterectomy simulator and brief didactic session was an effective way to increase resident knowledge and comfort of abdominal hysterectomy.