Baldwin Maureen K, Chor Julie, Chen Beatrice A, Edelman Alison B, Russo Jennefer
J Grad Med Educ. 2013 Dec;5(4):662-4. doi: 10.4300/JGME-D-13-00049.1.
Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation (D&E) have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester D&E training.
We report physicians' assessments of the realism of 3 D&E models to establish a composite training model.
We surveyed experienced providers at 2 national conferences to evaluate 3 D&E models and rate each model's components on a Likert scale.
Fifty-five obstetrics-gynecology and family medicine physicians completed the survey. Most respondents rated 4 components of 1 model as somewhat realistic or very realistic. The components rated highest were the fetal parts (82% [45 of 55]) and placenta (60% [30 of 50]). This model was rated as more likely to be used in training by 80% (43 of 54) of participants than the 2 other models, as rated by 28% (15 of 54) and 9% (5 of 54) of participants.
A model made from a plastic bottle containing a stuffed fabric form with detachable parts has tactile similarity to a D&E procedure and should be further developed for testing and training.
模拟训练可提高患者安全性，降低培训者和受训者的焦虑，并减少达到胜任能力所需的病例数量。扩张刮宫术（D&E）相关并发症与医疗服务提供者的技术水平直接相关，但在文献中尚未有针对孕中期D&E培训的低仿真模型被正式描述或评估。
我们报告医生对3种D&E模型逼真度的评估，以建立一个综合培训模型。
我们在2次全国性会议上对经验丰富的医疗服务提供者进行调查，以评估3种D&E模型，并使用李克特量表对每个模型的组件进行评分。
55名妇产科和家庭医学医生完成了调查。大多数受访者将1种模型的4个组件评为有些逼真或非常逼真。评分最高的组件是胎儿部分（82%[55人中的45人]）和胎盘（60%[50人中的30人]）。与另外2种模型相比，80%（54人中的43人）的参与者认为该模型更有可能用于培训，而另外2种模型的这一比例分别为28%（54人中的15人）和9%（54人中的5人）。
一种由装有带可拆卸部件的填充织物模型的塑料瓶制成的模型在触觉上与D&E手术相似，应进一步开发用于测试和培训。
