Assessing the Impact of Repeated Simulation of 4th Degree Lacerations on Resident Competency

Abstract

Faculty Advisor: Steven Swift, MD PURPOSE: To determine if a periodic educational intervention on 4th degree perineal laceration leads to improved resident procedural competency in a simulated environment as evaluated by a task-specific objective structured assessment of technical skills (OSATS) checklist. BACKGROUND: Improper repair of 3rd or 4th degree perineal lacerations can lead to detrimental long-term sequelae. Given the lack of adequate resident exposure to such lacerations, improved education may be essential in decreasing adverse outcomes. A technique to provide experience and assess competency with rare procedures is the simulation lab employing a task-specific OSATS checklist. This involves using simulation models and can be implemented as a teaching tool to reliably and validly assess procedural skills in a formal, structured manner outside of the clinical setting. Current literature is limited by short follow-up and lack of an appropriate control group. METHODS: Participants were randomized into a control or intervention group. All participants completed a validated task-specific OSATS pre-test followed immediately by an educational intervention on 4th degree lacerations. Those randomized to the intervention group received a second educational session whereas those in the control group did not. All participants then completed a post-test six months after study initiation. RESULTS: Six participants were in the control group and seven in the intervention group. There was no difference in the change of mean scores (5.5 vs. 3.9, respectively) between groups (P=.66). DISCUSSION: In this study with a small sample size, a supplementary educational intervention did not affect OSATS scores over a 6-month time period.