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Creation of a Low Fidelity Bladder Model for Cystotomy Repair in Resident Education
Purpose: To create and assess a low fidelity bladder model for laparoscopic cystotomy simulation curriculum for resident education.
Background: The American College of Obstetrics and Gynecology has emphasized that laparoscopic suturing and simulation training should be utilized in resident education.
Methods: This was a prospective cohort at 2 institutions (IRB exempt). Sessions included cystotomy didactics and suture training using the low fidelity bladder model created with a whoopie cushion, shelf liner and plastic wrap. Residents had 20 minutes to suture and complete the laparoscopic cystotomy repair. Investigators evaluated residents unblinded using a pre and post knowledge questionnaire as well surgical skills using the objective structured assessment of technical skill (OSATS) task specific checklist (TSS) and Global rating scale (GRS).
Results: Thirty-nine residents participated, (PGY1-31%, PGY2-28%, PGY3-26%, PGY4-15%). There was significant improvement in all knowledge questions and the average correct score for the OSATS TSS was 89.3 (SD 9.1). Zero residents completed the timed laparoscopic repair limiting our ability to perform the OSATS GRS. Ninety-seven percent of residents reported the session exposed them to new skills but 92.3% of residents reported that they still needed additional training in cystotomy repairs after the simulation sessions.
Discussion: Our bladder cystotomy simulation exposed residents to a new skill and improved resident knowledge. In addition, our study identified a significant surgical educational gap in laparoscopic suturing skills with 0/39 residents able to complete the laparoscopic cystotomy repair in 20 minutes. Given these facts, we recommend that OBGYN residencies focus more efforts on laparoscopic suturing simulation.
Topics:
SES, 2023,
