Effects of a structural simulation curriculum for the repair of obstetrical anal sphincter injuries.

Abstract

To assess the short-term and skill-retention effects of a structural simulation curriculum for the repair of obstetrical anal sphincter injuries (OASIS). This prepost experimental study recruited 31 obstetrics and gynecology residents from Peking Union Medical College Hospital. OASIS repair skill evaluations (at all timepoints) comprised a task-specific checklist (TSC), global rating scale (GRS), and pass/fail grade. A beef-tongue model was adopted in the simulation curriculum. After baseline testing, residents completed a structured 1-h workshop. Two weeks later, a second test was performed, followed by a one-to-one teaching workshop, with the proper completion of a checklist as the end-point. Three months later, residents completed a third test. The overall pass rate at baseline was 16.1%, with higher GRS scores (p= 0.035) in senior residents. Additionally, previewing the procedure before class and a history of OASIS repair observation were associated with higher TSC and GRS scores. Significant skill improvement was observed in the second and third tests, with pass rates of 96.8% and 93.5% respectively. Both TSC and GRS scores were improved compared with baseline (p< 0.001). A structural simulation curriculum integrating deliberate practice under supervision improves OASIS repair competence and achieves satisfactory skill retention.