Purpose: This study aimed to assess a novel cervical cerclage model
for resident training.
Background: Vaginal suturing can be challenging to teach and to
learn due to limited operative field visualization by the surgical assistant,
but is a required skill for cervical cerclage placement. There is limited data
on resident training and comfort with cerclage placement using models1,2.
Methods: Residents in Obstetrics and Gynecology (OBGYN) at
George Washington University were recruited to participate in a pre and
post-test survey during a cerclage simulation training with a novel model. A
cervical cerclage model was assembled using a 1 L water bottle, sutures and a
“hair bun” maker. Continuous variables were compared using 2 tailed paired t
tests.
Results: A total of 20 residents participated with a median of
2 ± 1.6 years of OBGYN residency. 95% of residents reported no prior cerclage
simulation training; however, 60% reported previously placing cerclages in
practice. Pre and post-test analysis showed a decrease in the perception of
need for further training (4.05 ± 1.07 vs. 3.45 ± 0.86; p = 0.024) and resident
reported more comfort performing the procedure with decreasing supervision
(2.05 ± 1.02 vs. 2.3 ± 1.01; p = 0.021). 90% reported learning to place a
cerclage was easy after the simulation, versus 45% beforehand.
Discussions: A novel cervical cerclage model in a training session
significantly increased resident knowledge of and comfort regarding cerclage
placement. Future research should replicate this study, focusing on
learner achievement of clinical competency and evaluate clinical outcomes.
Topics: CREOG & APGO Annual Meeting, 2019, Faculty, Clerkship Director, Residency Director, Patient Care, Medical Knowledge, GME, Simulation, Maternal-Fetal Medicine, General Ob-Gyn,
Arlin Delgado,
BS, The
George Washington University School of Medicine and Health Sciences; Rachael Cleberg,
MD; Alexis
Gimovsky, MD