Faculty of Medicine of Botucatu, University of Sao Paulo State, São Paulo, Brazil.
Faculty of Medicine, Educational Foundation of the Municipality of Assis, São Paulo, Brazil.
Int J Gynaecol Obstet. 2024 Sep;166(3):1121-1126. doi: 10.1002/ijgo.15508. Epub 2024 Mar 30.
To determine the reliability of the Carousel simulator in medical education for obstetric examinations. Cervical dilation examination training in pregnant women exposes patients to additional uncomfortable and health-risk procedures, a gold standard, and does not objectively evaluate the medical student's competence.
We studied the reliability of training internship medical students in obstetrics. Participating students were assigned to take the examination of digital assessment of the cervical dilation on the simulator. Classes performed 12 consecutive randomly blind predetermined cervical dilation examinations using the Carousel simulator. The exact answer and the answer with certainty within ±1 cm were registered and analyzed. Incorrect or outlier answers were considered with a cutoff of ≥2 cm from the dilation. A dispersion graph for each centimeter of dilation simulation was constructed.
Sixty-six medical obstetricians took part, performing 396 examinations. Thus, we observed 49 outliers (12.37%) in simulated assessments. According to the analysis, we did not observe outliers from dilation 1 to 4 cm; dilation 7 to 9 cm had a higher index of outlier measurements. We did not consider any dilation simulation dispersion graphic as a null correlation. A strong correlation was seen in the dilation 1 to 6 cm and the dilation 10 cm. The dilations 7, 8, and 9 cm showed a weak correlation.
The Carousel simulator model is a reliable method for student learning. The simulator is an essential study tool capable of reducing the embarrassment and possible harm caused by the excessive and repetitive number of in vivo digital vaginal examinations. Novel studies are proposed to improve the simulator device and method, mainly to estimate the adequate repetitions and training needed before in vivo practice.
确定 Carousel 模拟器在医学教育中进行产科检查的可靠性。对孕妇进行宫颈扩张检查培训会使患者面临额外的不适和健康风险，且这种培训方法不是金标准，也无法客观评估医学生的能力。
我们研究了 Carousel 模拟器在培训实习医学生进行产科检查方面的可靠性。参与研究的学生被分配到模拟器上进行数字评估宫颈扩张的检查。这些班级连续进行了 12 次随机盲测的预定宫颈扩张检查，使用 Carousel 模拟器进行。记录并分析了准确答案和在±1cm 内确定答案的情况。将超出 2cm 的答案视为错误或异常值。为每个模拟扩张厘米数构建了一个分散图。
66 名妇产科医生参与了研究，共进行了 396 次检查。因此，我们观察到模拟评估中有 49 个异常值（12.37%）。根据分析，我们在 1 至 4cm 扩张模拟中没有观察到异常值；7 至 9cm 扩张的异常值测量指数较高。我们没有将任何扩张模拟分散图视为零相关。在 1 至 6cm 扩张和 10cm 扩张中观察到强相关性。在 7、8 和 9cm 扩张中观察到弱相关性。
Carousel 模拟器模型是学生学习的可靠方法。模拟器是一种必不可少的研究工具，能够减少因过多和重复的阴道数字检查而带来的尴尬和潜在危害。建议开展新的研究来改进模拟器设备和方法，主要是估计在体内实践前需要进行的适当重复次数和培训。
