Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania (all authors)..
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania (all authors).
J Minim Invasive Gynecol. 2021 Aug;28(8):1526-1530. doi: 10.1016/j.jmig.2020.12.022. Epub 2021 Jan 13.
To establish face and construct validity for a novel variation of American College of Obstetrics and Gynecology "Flowerpot Model" for transvaginal hysterectomy (TVH) surgical simulation with improved vesicovaginal dissection during surgical education simulation.
Cross-sectional face and construct validation study using the "Flowerpot Model." The vesicovaginal dissection plane was modified to include additional felt and balloon materials to simulate the bladder.
Single academic center.
Fourteen residents and fellows, postgraduate year (PGY) 2 to 6, subdivided into junior (n = 8) with ≤10 prior TVH surgeries and senior groups (n = 6) with >10 prior TVH surgeries performed.
All subjects watched a brief introductory video and then were filmed simulating a TVH.
For face validity, subjects completed an anatomic checklist and pre/post simulation satisfaction survey. For construct validation, 2 independent, blinded expert surgeons (M.A. and J.M.) graded films using the Global Rating Scale of Operative Performance (GRS). Primary outcome was mean GRS between groups. The junior group consisted of PGY 2 to 3 with ≤ 10 prior TVH, median 7.5 (interquartile range [IQR] 6.75) and senior group PGY 3 to 6 with >10 TVH, median 19 (IQR 10) (p <.01). Subjects were "satisfied" or "very satisfied" with bladder and anterior peritoneal fold simulation (92%) and found vesicovaginal dissection "realistic" (100%). GRS score was significantly different between groups (juniors, 19.5 [IQR 5] vs seniors, 28.5 [IQR 8.5]; p = .048). Intergrader correlation was high (ρ = 0.87, p <.01). Surgeon volume of prior TVH was not significantly correlated to average GRS score, ρ = 0.49 (p = .10). The model improved comfort and confidence scores in the junior group more than senior group (p = .04), but senior group still had higher post simulation confidence scores than the junior group (p = .02).
Face and construct validity with the modified Flowerpot Model was demonstrated. This low fidelity model is capable of simulation of a TVH with a novel vesicovaginal dissection. Prior surgical experience was not correlated to GRS score or time to procedure completion.
为经阴道子宫切除术（TVH）手术模拟建立一种新的美国妇产科医师学院“花盆模型”的面部和结构有效性，该模型在手术教育模拟中改进了膀胱的阴道切开术。
使用“花盆模型”进行横截面面部和结构有效性研究。修改了阴道切开术平面，增加了额外的毛毡和气球材料来模拟膀胱。
单家学术中心。
14 名住院医师和研究员，PGY 2 至 6 岁，分为初级组（n=8），有≤10 例 TVH 手术史和高级组（n=6），有>10 例 TVH 手术史。
所有受试者观看简短的介绍视频，然后模拟 TVH 进行拍摄。
为了进行面部有效性评估，受试者完成了解剖学检查表和模拟前后的满意度调查。为了进行结构有效性验证，2 名独立的、盲目的专家外科医生（M.A. 和 J.M.）使用手术操作性能全球评分量表（GRS）对影片进行评分。主要结果是组间平均 GRS。初级组由 PGY 2 至 3 岁，≤10 例 TVH 手术史，中位数 7.5（四分位距 [IQR] 6.75）和高级组 PGY 3 至 6 岁，>10 例 TVH 手术史，中位数 19（IQR 10）（p<0.01）。受试者对膀胱和前腹膜折叠的模拟表示“满意”或“非常满意”（92%），并认为阴道切开术“逼真”（100%）。组间 GRS 评分差异有统计学意义（初级组 19.5 [IQR 5] vs 高级组 28.5 [IQR 8.5]；p=0.048）。评分者间相关性很高（ρ=0.87，p<0.01）。既往 TVH 手术量与平均 GRS 评分无显著相关性，ρ=0.49（p=0.10）。与高级组相比，初级组模型提高了舒适度和信心评分（p=0.04），但高级组的模拟后信心评分仍高于初级组（p=0.02）。
改良花盆模型具有面部和结构有效性。这种低保真模型能够模拟具有新阴道切开术的 TVH。既往手术经验与 GRS 评分或手术完成时间无关。
