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Novel Realistic Model Improves Medical Student Confidence in Performing Neonatal Circumcision
Purpose: 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.
Results: 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.
Topics:
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,
