Bartholin Gland Cyst Educational Simulation Improves Knowledge and Confidence

Abstract

PROBLEM: Our institution had an increasing number of ER consults for recurrent Bartholin gland cysts/abscesses between May of 2015 and June of 2016. The majority had incorrect placement of the incision and drainage site or limited or improper Word catheter use. Ob/Gyn, Family Medicine, and ER departments did not have specific training available for this diagnosis and treatment. INTERVENTION: We developed a simulation-based curriculum including a didactic presentation on Bartholin gland cyst/abscess diagnosis and treatment options, an instructional video demonstrating the steps of Bartholin gland cyst/abscess drainage with Word catheter placement, and supervised practice on an established Bartholin gland cyst model with feedback. Learner knowledge and confidence were assessed before and after the curriculum, and satisfaction with the simulation model for both I&D and Word catheter placement were assessed after the curriculum. CONTEXT: UTMCK has residencies for Ob/Gyn and Family Medicine with protected education time. There is an ER fellowship but most ER providers are ER physicians and PA’s with limited time for group learning. OUTCOME/LESSONS LEARNED: Implementation with 26 Ob/Gyn residents and 5 medical students showed increases in learner confidence and some aspects of knowledge. Participants were highly satisfied with the simulation model. Curriculum delivery will need to be tailored to the different specialties. Family Medicine residents are scheduled to complete the group training in January 2019 but the ER providers have requested to complete the training as self-study modules due to shift restrictions.