An Interactive Holographic Curriculum for Urogynecologic Surgery.

Abstract

Urogynecologic surgery, transvaginal pelvic floor surgery in particular, requires learning by feel and high-volume pattern recognition. In the era of limited duty hours and case numbers, we sought to develop a curriculum, one that can be self-guided, to help trainees develop a spatial understanding of the relationships of pelvic floor musculature, ligamentous supports, and surrounding neurovasculature outside of the operating room. We created and piloted an innovative interactive holographic using an augmented reality headset to teach surgical anatomy, procedural steps, recognition, and management of the uterosacral ligament suspension and sacrospinous ligament fixation, the two most common native tissue vaginal prolapse repairs. Our curriculum was independently trialed by obstetrics and gynecology residents and subspecialty fellows and was widely accepted by trainees, postgraduate levels 1-6. As compared with usual self-study, 88% ranked the modules as "much" or "very much better" and 81% would be "likely" or "very likely" to use mixed reality smartglasses to prepare for surgery. This interactive holographic curriculum is a novel technique to teach complex pelvic floor anatomy, key steps, and management of complications of the uterosacral ligament suspension and sacrospinous ligament fixation. It is widely accepted by obstetrics and gynecology residents and gynecologic subspecialty fellows.