Benson James E, Hillebrand Allix M, Auguste Tamika
From the Obstetrics and Gynecology Department (J.E.B.), MedStar Georgetown University Hospital; Georgetown University School of Medicine (A.M.H.); and Obstetrics and Gynecology Department (T.A.), MedStar Washington Hospital Center, Washington, DC.
Simul Healthc. 2017 Dec;12(6):414-421. doi: 10.1097/SIH.0000000000000252.
Learning how to perform a speculum examination is a key component of the medical student curriculum, yet there is a paucity of data on the validity of available speculum examination models. This purpose of this study is to design, evaluate, and improve a low-cost speculum examination model.
A speculum examination training model was created using low-cost or recycled materials from other simulators. A total of 54 medical students, residents, and faculty in the obstetrics and gynecology department of a single academic institution performed speculum examinations on the model. Each participant completed a survey to provide qualitative and quantitative data. Using this feedback from participants, adjustments were made to the model and a similar survey was repeated with a total of 35 medical students and residents.
The first iteration of the model was viewed positively by most participants. Eighty-three percent gave the model either a very realistic or realistic rating. Ninety-four percent thought the model was a very useful or useful teaching device. There were few significant differences in quantitative data based on experience level. Qualitative feedback yielded generally positive remarks with areas for improvement. The second iteration of the model was successful in differentiating between novice and skilled participants: residents were significantly better at identifying cervical position compared with students. Eighty-nine percent of participants thought the model was very useful or useful, whereas 49% thought the model was very realistic or realistic.
The first iteration of the model demonstrated realism and usefulness; however, it lacked construct validity. Participant feedback yielded several helpful suggestions to improve the model. The second and final iteration of the model differentiated between novice and skilled participants at the cost of realism. This low-cost model is a useful tool to aid in teaching the speculum examination. Further development and study of the model could lead to a valid tool to evaluate speculum examination skills.
