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Development of a Low-Fidelity Simulation Model and Curriculum for Internal Iliac Artery Ligation for Obstetrics & Gynecology Residents and Fellows
Purpose: To assess the face, content and construct validity of a novel 3-D printed pelvic dissection model for the surgical training of obstetrics and gynecology residents and fellows. To assess a self-directed and simulation-based curriculum of retroperitoneal pelvic dissection and internal iliac ligation.
Background Knowledge in dissection of the retroperitoneal space and identification of pelvic anatomy is required for many high-complexity gynecologic surgical tasks. Hypogastric artery ligation is a recognized method to control profuse pelvic bleeding, but few obstetricians and gynecologists acquire enough experience to perform this task.
Methods: A novel 3-D printed pelvic dissection model was designed with a medical illustrator following collaboration among APGO Surgical Education Scholars from 6 academic centers. A self-directed curriculum focused on internal iliac artery ligation was developed using published literature, a recorded lecture, and a video of retroperitoneal dissection including identification of pertinent anatomy. Trainees were oriented to the pelvic simulation model following review of this curriculum and were recorded performing the steps of opening the retroperitoneal space and ligating the internal iliac artery. A 10-step task specific checklist assessed trainee performance in a de-identified and randomized fashion. Trainees’ knowledge and perceived effectiveness of the simulation model were assessed prior to starting the curriculum and after completion of the simulation session.
Results: Currently, 51 trainees have thus far completed the simulation, with 35 recordings available for assessment. The mean score of task completion was 8.8, with an average time of 229.9 seconds. Data collection is ongoing with simulation sessions planned to complete the assessment of a total of 124 trainees. At this point, 52 trainees have completed the pre- and post- knowledge assessments.
Discussion: Once all subjects complete the curriculum and simulation exercises, the complete dataset will be analyzed to assess the validity of the model and the utility of the curriculum. Findings will be submitted for publication.
Topics:
SES, 2023,
