EMIG Simulation Systems Construct Validation Trial: Hysteroscopic Component

Abstract

<h3>Study Objective</h3> Construct validation of the EMIG Hysteroscopic Surgery Simulation System. <h3>Design</h3> A prospective, controlled cohort comparison. <h3>Setting</h3> Thirteen teaching institutions in the US and Canada and an AAGL Congress. <h3>Patients or Participants</h3> 240 subjects who fit one of 4 categories of exposure to hysteroscopic surgery and surgical simulation: 76 novices within 100 days of starting posgraduate year 1 (PGY-1); 69 within the first 100 days of starting PGY-3; 27 American Board of Obstetrics and Gynecology (ABOG) certified and no additional fellowship training ("Proficient"); 43 who had completed the two-year Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). <h3>Interventions</h3> Subjects were oriented to the simulation system and then tested under proctor supervision on the 2 EMIG hysteroscopic exercises. These included the Targeting Exercise (H-1); and the Polyp Removal Exercise (H-2). Time and accuracy scoring were entered electronically on site, but sessions were video recorded and stored for subsequent review to optimize data quality. <h3>Measurements and Main Results</h3> Each exercise was timed, and a number of objective metrics recorded that were designed to assess accuracy, efficiency and technique. Each exercise had a "time cap"; if a subject had not completed the exercise in by the end of the alloted time, they were categorized as "Did Not Complete" and the maximum time was entered for data analysis. Preliminary data analysis demonstrates that for both H-1 and H-2 the novice group consistently demonstrated the poorest performance and the FMIGS cohort consistently the best. The PGY-3 and "Proficient" cohorts were generally similar to each other but each performed better than the PGY-1 group and well below the FMIGS group. <h3>Conclusion</h3> The EMIG Hystroscopic Simulation System can be used to distinguish amongst PGY-1, PGY-3, Proficient and FMIGS subjects. FMIGS-trained subjects consistently had the best results.