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Laparoscopic Vascular Injury Simulation for Gynecology Residents

Objective: To improve resident competence in managing laparoscopic vascular injuries via simulation.

Methods: Residents participated in a simulated laparoscopic procedure. A mannequin containing basic vascular anatomy allowed for bleeding to occur. Residents participated in the simulation, underwent a debriefing, attended a lecture on the management of vascular injury, and then repeated the simulation. Residents took a pre-test, an immediate post-test, and a late post-test two weeks later. The tests contained survey questions, knowledge-based questions, and a free-text portion to simulate dictation.

Results: Twelve residents participated. Two (17%) had ever been involved in a vascular injury. Two (17%) had ever received prior instruction on management of vascular injury. The paired t-test was used to analyze the data. Knowledge scores improved from 48% on the pre-test to 88% on the early post-test (p<0.001) and 74% on the late post-test (p=0.002). Qualitative dictation scores improved from 11% on the pretest to 43% on the early post-test (p=0.005) and 30% on the late post-test (p=0.009). Resident confidence improved from 4% on the pre-test to 42% on the early post-test (p<0.001) and 56% on the late post-test (p<0.001). 100% felt the simulation was either quite helpful or extremely helpful. 100% wanted it repeated annually.

Conclusion: Our residents rarely see laparoscopic vascular injuries or learn about their management. This simulation showed a meaningful, statistically significant, and durable improvement in resident knowledge, confidence, and dictation quality. It was widely accepted by the residents and unanimously chosen to be part of the annual curriculum.

Topics: CREOG & APGO Annual Meeting, 2015, Resident, Patient Care, GME, Simulation, Minimally Invasive Surgery,

General Information

Date Presented
2015 Oral Abstract

Keywords
Instructional Materials/Methods, Simulation

Intended Audience
Resident

Copentencies Addressed
Patient Care

Educational Continuum
GME

Educational Focus
Simulation

Clinical Focus
Minimally Invasive Surgery 

Intended
Audience
Resident,
Competencies
Addressed
Patient Care,
Educational
Continuum
GME,
Educational
Focus
Simulation,
Clinical Focus
Minimally Invasive Surgery,

Author Information

Primary Author
Christina A. Saad, MD, MBA
Cedars-Sinai Medical Center, Los Angeles, CA

Secondary Authors
David S. Kim, MD, PhD, MBA, M. Jonathon Solnik, MD, Melissa S. Wong, MD 

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