Dumont Tania, Hakim Julie, Black Amanda, Fleming Nathalie
Division of Gynecology, Children's Hospital of Eastern Ontario, and Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Division of Gynecology, Children's Hospital of Eastern Ontario, and Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
J Pediatr Adolesc Gynecol. 2016 Jun;29(3):276-9. doi: 10.1016/j.jpag.2015.10.015. Epub 2015 Oct 29.
To determine the effect of an advanced pelvic simulation curriculum on resident performance on a pediatric and adolescent gynecology (PAG) focused objective structured clinical examination (OSCE).
Obstetrics and gynecology residents in a single academic Canadian center participated in a PAG simulation curriculum. An OSCE on prepubertal vaginal bleeding was administered at the biannual OSCE examination 2 months before the simulation curriculum and again 3 months after the simulation curriculum.
Academic half-day at the University of Ottawa Skills and Simulation Centre.
Obstetrics and gynecology residents from the University of Ottawa.
Participants completed 4 stations teaching PAG-appropriate history-taking, genital examination, Tanner staging, vaginal sampling and flushing, hymenectomy, vaginoscopy, laparoscopic adnexal detorsion, and approach to the child and/or adolescent. Advanced pelvic models were used for procedure-specific stations.
The primary outcome measure was change in mean score on a prepubertal vaginal bleeding OSCE station. Secondary outcome measures were changes in individual component scores.
Fourteen residents completed the simulation curriculum and the PAG OSCE at the 2 separate time points (before and after simulation curriculum). The mean OSCE score before the simulation curriculum was 54.6% (20.5 of 37) and mean score after the curriculum was 78.1% (28.9 of 37; P < .001). Significant score increases were found in history-taking, examination, differential diagnosis, identification of organism, surgical procedures, and identification of foreign body (P < .01 for all).
This innovative PAG simulation curriculum significantly increased residents' knowledge in PAG history-taking, examination skills, operative procedures, and approach to the child and/or adolescent. Obstetrics and Gynecology Program Directors should consider incorporating PAG simulation training into their curriculum to ensure that residents meet their learning objectives and increase their knowledge and confidence, which will ultimately benefit patient care.
确定一门先进的盆腔模拟课程对住院医师在以儿科和青少年妇科（PAG）为重点的客观结构化临床考试（OSCE）中的表现的影响。
加拿大一个学术中心的妇产科住院医师参加了一门PAG模拟课程。在模拟课程前2个月的半年一次的OSCE考试时以及模拟课程后3个月，分别进行了一次关于青春期前阴道出血的OSCE。
渥太华大学技能与模拟中心的学术半天时间。
渥太华大学的妇产科住院医师。
参与者完成了4个站点的学习，内容包括适合PAG的病史采集、生殖器检查、坦纳分期、阴道取样和冲洗、处女膜切除术、阴道镜检查、腹腔镜附件扭转复位术以及对儿童和/或青少年的诊疗方法。针对特定操作的站点使用了先进的盆腔模型。
主要观察指标是青春期前阴道出血OSCE站点的平均分数变化。次要观察指标是各个组成部分分数的变化。
14名住院医师在2个不同时间点（模拟课程前后）完成了模拟课程和PAG OSCE。模拟课程前的OSCE平均分数为54.6%（37分中的20.5分），课程后的平均分数为78.1%（37分中的28.9分；P < .001）。在病史采集、检查、鉴别诊断、病原体识别、外科手术以及异物识别方面发现分数有显著提高（所有P < .01）。
这一创新的PAG模拟课程显著提高了住院医师在PAG病史采集、检查技能、手术操作以及对儿童和/或青少年的诊疗方法方面的知识。妇产科项目主任应考虑将PAG模拟培训纳入其课程，以确保住院医师实现其学习目标并增加知识和信心，这最终将有利于患者护理。
