University of Bristol School of Clinical Sciences, RISQ Research, Southmead Hospital, Bristol, UK.
Department of Obstetrics and Gynecology, Taunton and Somerset NHS Foundation Trust, RISQ Research, Taunton, UK.
Int J Gynaecol Obstet. 2014 Mar;124(3):270-3. doi: 10.1016/j.ijgo.2013.09.016. Epub 2013 Dec 4.
To test a novel set of pelvic trainers for realism and construct validity.
Seven models of the female pelvis were studied. Participants performed speculum and bimanual examinations, documented their findings, and recorded opinions of the models in a structured questionnaire. Results were analyzed by participant grade (inexperienced and experienced).
Twenty-six inexperienced and 24 experienced gynecologists participated. Experienced doctors were more likely to correctly identify the uterus corresponding to 16 weeks of gestation (P<0.001), the large fibroid uterus (P=0.01), and uterine anteversion (P=0.04). Identification of the uterus containing a small fibroid, the uterus corresponding to 10 weeks of gestation, and an adnexal cyst was low overall (<35%) and not significantly different between the groups. Correct identification of cervical findings (ectropion and polyp) was high in both groups (65%-88%). Experienced doctors were more consistent-with 17 (71%) reporting the same correct finding on a repeated model, compared with 8 (31%) inexperienced doctors. Forty-nine (98%) doctors completed the structured questionnaire, 36 (73%) of whom felt the models were realistic.
The models were found to be realistic and have construct validity. Senior participants were consistent at correctly identifying most abnormalities. The models may be useful for pelvic examination training; further testing is required regarding their ability to aid learning of clinical and communication skills.
测试一套新的骨盆训练器的逼真度和结构有效性。
研究了 7 个女性骨盆模型。参与者进行阴道镜和双手检查,记录他们的发现,并在结构化问卷中记录对模型的意见。结果按参与者的级别(无经验和有经验)进行分析。
26 名无经验和 24 名有经验的妇科医生参与了研究。有经验的医生更有可能正确识别出对应 16 周妊娠的子宫(P<0.001)、大的纤维瘤子宫(P=0.01)和子宫前倾(P=0.04)。总体而言,识别出含有小纤维瘤的子宫、对应 10 周妊娠的子宫和附件囊肿的能力较低(<35%),且两组之间无显著差异。两组的宫颈发现(外翻和息肉)的正确识别率均较高(65%-88%)。有经验的医生更一致——17 名(71%)医生在重复模型上报告了相同的正确发现,而无经验的医生只有 8 名(31%)。49 名(98%)医生完成了结构化问卷,其中 36 名(73%)医生认为模型逼真。
模型被发现具有逼真度和结构有效性。高级参与者在正确识别大多数异常方面具有一致性。这些模型可能对骨盆检查培训有用;需要进一步测试它们在帮助学习临床和沟通技能方面的能力。