Simulation Training and Skill Assessment in Obstetrics and Gynecology

Simulation is a valuable teaching tool that increases skill and knowledge acquisition in obstetric and gynecologic clinical scenarios. There are increasing options for simulation from animal and human cadaver, low-fidelity (inanimate simulator), and virtual reality simulation. The role of obstetric and gynecologic simulation also plays a key role in both outcomes-based as well as competency-based medical education.  Simulators were initially created for flight training for pilots in the 1920s, and the ability to reproduce clinical situations has been utilized in obstetric and gynecologic education. Simulations used in medical training were used in the 1960s with standardized patients and mannequins. Simulation has continued to evolve with the development of simulation software for medical education in the 1980s. Simulation is an effective way for residents and students to develop their skills in a safe learning environment. Simulation offers a realistic approach to practice such skills without the potential to cause harm to a living patient. Although the reduction in duty hours has shown to improve standardized examination scores for residents, residents may not encounter specific cases due to the decreased volume. Simulation allows residents and students to encounter case scenarios and skills that in a reproducible environment. Standardized patients provide simulated learning interactions with patients. It is advantageous to practice and model procedures and simulated scenarios in obstetrics and gynecology. Clinical simulation encounters offer learning skills for standard delivery, postpartum hemorrhage, instrument deliveries, shoulder dystocia, fetal malpresentation, massive blood transfusion protocol, disseminated intravascular coagulation, or amniotic fluid emboli. Laparoscopic and robotic operative simulations facilitate operative skills for hysterectomy, oophorectomy, salpingectomy, and access to the abdomen.