Purpose: To solidify comfort and proficiency with energy sources, uterine manipulators, instrumentation set-up, and steps of laparoscopic entry in gynecologic surgery.
Background: Surgical simulation is an important part of OBGYN resident training. Requiring FLS for board certification has increased standardized psychomotor skills training. However, these skills are only beneficial once a surgeon has successfully set-up their surgical field and gained abdominal entry.
Methods: Residency educators prepared a 3.5 hour educational session for PGY 1 and 2 OBGYN residents focused on laparoscopic gynecologic surgery. The session involved a high-fidelity simulation employing Noelle as a surgical patient in a real-OR setting. The supervising instructor used a checklist to monitor residents’ completion of several tasks, including patient positioning, draping, instrument set-up, trocar placement, communication, and situational awareness, followed by a de-brief. A pre- and post-session survey was administered to evaluate resident self-assessed knowledge, comfort with the material, and satisfaction with the session.
Results: Fourteen residents were involved in the session (6 PGY-1 and 8 PGY-2), which took place in October 2019. A paired t-test demonstrated a 17% improvement (p=0.0013) between the pre- and post-survey. The biggest improvement in mean score was associated with knowledge regarding uterine manipulators and correlated with answers to open-ended questions. Overall feedback for the session was very positive.
Discussions: Hands on time with instruments outside of the OR is a valuable process to improve resident knowledge. Unexpectedly, residents benefitted most from hands-on instruction with uterine manipulators. It is important not to overlook instruction in basic instrumentation as part of a well-rounded simulation curriculum.
Topics: CREOG & APGO Annual Meeting, 2021, Resident, Faculty, Clerkship Director, Residency Director, Patient Care, Medical Knowledge, Interpersonal & Communication Skills, GME, Virtual Patient, Simulation, Team-Based Learning, Minimally Invasive Surgery, General Ob-Gyn,
Ashley Gubbels, MD, University of Rochester Medical Center; Kyan Lynch, MD, MA; Kristen Burhans, MD
