From the Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX.
Female Pelvic Med Reconstr Surg. 2021 Oct 1;27(10):637-641. doi: 10.1097/SPV.0000000000001018.
This study aimed to assess the subjective and objective cystoscopy skills of gynecology residents before and after implementation of a comprehensive simulation curriculum.
Residents in an obstetrics/gynecology program at a single academic institution participated in a 6-week cystoscopy simulation course. Residents attended an initial orientation and didactic presentation, and then weekly 20- to 30-minute training sessions using a water balloon model and a virtual reality simulator. Pretesting and posttesting were performed, including (1) subjective self-assessments, (2) a written quiz, and (3) objective structured assessment of technical skills. Paired t test was used to assess the differences in residents' objective assessment scores before and after simulation training.
A total of 16 residents were recruited. Residents reported significant subjective improvements in comfort, confidence, and proficiency in performing cystoscopy after completing the curriculum. Their overall objective assessment improved, including written quiz scores (mean score, 49% vs 78%; P < 0.001), efficiency in cystoscope assembly (means score, 0 vs 4; P < 0.001), overall bladder survey score (56% vs 86%, P < 0.001), and global rating score (mean score, 15 vs 24; P < 0.001). Residents tended to prefer the water-balloon model compared with the virtual reality simulator (75% vs 25%).
Obstetrics/gynecology residents demonstrated significant improvements in subjective and objective measures of skill after completion of a 6-week cystoscopy simulation training course using a combination of low- and high-fidelity models. Although universal cystoscopy at the time of hysterectomy for benign indications remains controversial, cystoscopy simulation should remain an important part of resident training.
本研究旨在评估妇科住院医师在实施综合模拟课程前后的主观和客观膀胱镜检查技能。
在一家学术机构的妇产科项目中，住院医师参加了为期 6 周的膀胱镜模拟课程。住院医师参加了初始定向和讲座，然后每周进行 20-30 分钟的培训，使用水球模型和虚拟现实模拟器。进行了预测试和后测试，包括（1）主观自我评估，（2）书面测验，以及（3）技术技能的客观结构化评估。配对 t 检验用于评估模拟培训前后住院医师客观评估分数的差异。
共招募了 16 名住院医师。住院医师报告在完成课程后，在进行膀胱镜检查时舒适度、信心和熟练度方面有显著的主观改善。他们的整体客观评估得到改善，包括书面测验分数（平均分数，49%比 78%；P<0.001）、膀胱镜组装效率（平均分数，0 比 4；P<0.001）、整体膀胱检查评分（56%比 86%，P<0.001）和总体评分（平均分数，15 比 24；P<0.001）。住院医师倾向于喜欢水球模型而不是虚拟现实模拟器（75%比 25%）。
在使用低和高保真模型的组合完成 6 周的膀胱镜模拟培训课程后，妇产科住院医师在技能的主观和客观测量方面都有显著提高。尽管在良性指征下进行子宫切除术时普遍进行膀胱镜检查仍存在争议，但膀胱镜检查模拟仍应成为住院医师培训的重要组成部分。
