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Novel Realistic Model Improves Medical Student Confidence in Performing Neonatal Circumcision
To develop and pilot an inexpensive, reusable, moderate-fidelity model to teach neonatal circumcision.Background:
CREOG recommends that graduating residents should understand and independently perform neonatal circumcision with anesthesia. This procedure is often performed by first-year residents (PGY-1), however, limited exposure during undergraduate clinical rotations and to simulation may impact ability and confidence in performing circumcisions. Our goal is to create a cost-effective, realistic penile model for neonatal circumcision simulation with novice learners, as current models are either too expensive or low-fidelity.
Methods: Phase 1: Creation of a realistic silicone neonatal penile model with replaceable foreskins using 3D design/printing. The model’s flat silicone circular base facilitates dorsal penile block and allows the model to stand independently.
Phase 2: Pilot of the model with fourth-year medical students during their Ob-Gyn residency preparatory course. Pre- and post-simulation, students completed a questionnaire identifying prior experience performing circumcision and rated their confidence in identifying procedural steps and performing neonatal circumcision. Students also evaluated the model’s fidelity.
Five reusable penile models with replaceable foreskins were constructed for $83 each. All students (n=7) correctly identified model anatomy and successfully performed circumcision using a 1.45cm Gomco clamp. Students had no prior circumcision simulation and limited procedure performance experience. Students strongly agreed the model was realistic (mean 4.14/5). The model improved confidence in identifying procedural steps (2.1 vs 4.6 of 5, p= 0.004) and performing circumcision (1.4 vs 3.9 of 5, p= 0.001).Discussions:
Our penile model is cost-effective, realistic, and useful for teaching neonatal circumcision with anesthesia. Data collection is ongoing.
CREOG & APGO Annual Meeting, 2021, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Patient Care, Medical Knowledge, Practice-Based Learning & Improvement, GME, Simulation, General Ob-Gyn,