Delgado Arlin, Cleberg Rachael, Gimovsky Alexis C
Obstetrics and Gynecology Resident, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine.
Physician, Capital Women's Care, Division 44.
MedEdPORTAL. 2021 Mar 2;17:11102. doi: 10.15766/mep_2374-8265.11102.
Vaginal suturing can be challenging to teach and learn due to the surgical assistant's limited operative field visualization. Data on resident training and comfort with cerclage placement using models are limited. The aim of this activity was to assess learner satisfaction with practice using a novel model allowing for full visualization during transvaginal cervical cerclage placement.
OB/GYN residents participated in a 1-hour combined lecture and hands-on cerclage training simulation with the novel model. Pre- and postsession survey responses were assessed with descriptive statistics and paired tests.
Twenty residents with a median of 2 ( = 1.6) years of residency experience participated. Ninety-five percent reported no prior cerclage simulation training; 60% reported placing cerclages in practice. Pre- and posttest analysis indicated a significant decrease in perceived need for further training ( = 4.05, = 1.07, vs. = 3.45, = 0.86; = .024) and an increase in comfort performing a cerclage placement ( = 2.55, = 1.16, vs. = 3.85, = 0.79; < .001). After the simulation, residents reported more comfort in cerclage placement with decreasing supervision ( = 2.05, = 1.02, vs. = 2.30, = 1.01; = .021); 90% reported that learning to place a cerclage was easy.
Implementing a novel, low-cost model allowing full operative field visualization significantly improved reported comfort regarding cervical cerclage placement and resulted in high satisfaction amongst residents. Future research should evaluate the training's impact on clinical skills.
由于手术助手的手术视野可视化受限，阴道缝合的教学和学习可能具有挑战性。关于住院医师使用模型进行宫颈环扎术训练及熟练程度的数据有限。本活动的目的是评估学习者对使用一种新型模型进行练习的满意度，该模型在经阴道宫颈环扎术放置过程中可实现完全可视化。
妇产科住院医师参加了为期1小时的讲座和使用新型模型进行的宫颈环扎术实践模拟培训。会前和会后的调查反馈采用描述性统计和配对检验进行评估。
20名住院医师参与，中位住院年限为2（范围 = 1.6）年。95%的人报告之前没有接受过宫颈环扎术模拟训练；60%的人报告在实际操作中进行过宫颈环扎术。测试前和测试后的分析表明，对进一步培训的感知需求显著降低（测试前均值 = 4.05，标准差 = 1.07，测试后均值 = 3.45，标准差 = 0.86；P = 0.024），进行宫颈环扎术的熟练程度有所提高（测试前均值 = 2.55，标准差 = 1.16，测试后均值 = 3.85，标准差 = 0.79；P < 0.001）。模拟训练后，住院医师报告在监督减少的情况下进行宫颈环扎术更熟练（测试前均值 = 2.05，标准差 = 1.02，测试后均值 = 2.30，标准差 = 1.01；P = 0.021）；90%的人报告学习进行宫颈环扎术很容易。
采用一种新型、低成本且能实现手术视野完全可视化的模型，显著提高了报告的宫颈环扎术操作熟练程度，并使住院医师满意度很高。未来的研究应评估该培训对临床技能的影响。
