Purpose: To determine if focusing more on cervices of advanced dilation improves training.
Background: Repetitive simulation of the labor cervical exam is an effective training strategy. Cervices of higher dilation are more difficult to accurately estimate. Thus, focusing of these cervices could improve learning.
Methods: 3rd year medical students had introductory training and examined 10 sets of 10 cervical models throughout their OB/GYN clerkship using 2 training regimens. Regimen 1, used in rotations 1, 3, and 5, included cervical models with a random array of dilation and effacement. Regimen 2, used in rotations 2, 4, and 6, had more cervices with dilations of ≥5cm. Using cumulative summation to determine competency, the proportion of students achieving competency under Regimen 1 and Regimen 2 were compared using a Chi-Square test, and improvements in accuracy were compared using a Wilcoxon signed rank test.
Results: For dilation, 56% of students using Regimen 1 and 60% of students using Regimen 2 achieved competency (p=0.04). During the rotation, the improvement in the number of correct estimations was 1.4 and 2.3, respectively, (p=0.07). For effacement, 8% and 24% achieved competency, respectively (p=0.70). The improvement in the number correct was 0.7 and 1.1, respectively (p=0.22).
Discussions: There was a significant increase in competency and a trend toward a significant increase in accuracy in students whose simulation training had more cervices of high dilation compared to those with an equal distribution of cervical dilations. Thus, using cervices of higher dilations during training would likely improve training efficiency.
Topics: CREOG & APGO Annual Meeting, 2022, Student, Resident, Faculty, Clerkship Director, Osteopathic Faculty, Residency Director, Patient Care, GME, UME, Assessment, Simulation, General Ob-Gyn,
Joshua Nitsche, MD, PhD, Wake Forest School of Medicine; Brian C. Brost, MD