Comfort and Competency With Intrauterine Contraception Insertion

Abstract

INTRODUCTION: Different simulators are available to teach intrauterine contraception insertion. We compared self-perceived competence and comfort with intrauterine contraception insertions after practice on a high-fidelity simulator compared with a low-fidelity model. METHODS: In this randomized controlled trial, participants were assigned to practice intrauterine contraception insertions on the ARMS PelvicSim high-fidelity simulator or a coaster-like model. We enrolled family medicine interns, obstetrics and gynecology interns, and nurse practitioner students inexperienced with intrauterine contraception insertion (defined as having inserted less than five intrauterine contraception devices). Participants viewed a didactic module and intrauterine contraception insertion training videos before practicing on their assigned models. Before and after practicing they rated their comfort and competency with intrauterine contraception insertion. RESULTS: We enrolled 60 participants; 59 completed their study visit and one withdrew. Twenty-nine participants practiced on the ARMS PelvicSim and 30 on the coaster. Participants included 20 interns and 39 nurse practitioner students. Median age was 27.0 years (range 26.0–30.0 years) and 53 (89.8%) were female. After the training, both groups were similarly more comfortable with the steps of intrauterine contraception insertion (P=.24) as well as inserting the Mirena (P=.23), Skyla (P=.11), and ParaGard (P=.47). Self-perceived competency with these procedures improved for both groups regardless of simulator used (P>.05 for all). Twenty-six (92.7%) participants who used the ARMS PelvicSim thought their model was valuable compared with 17 (56.7%) who used the coaster (P=.007). CONCLUSION: Although participants who used the PelvicSim felt it was more valuable, the type of model used to practice intrauterine contraception insertion did not affect self-reported competency and comfort among trainees inexperienced with intrauterine contraception insertion.