Abstract
ObjectiveTo measure the impact of a model-based teaching program on resident comfort and skill with retropubic midurethral sling (MUS).Study designResidents were assessed before and after a retropubic MUS teaching session, which included a brief lecture and three interactive teaching stations (cadaver pelvis, retropubic MUS pelvic model, cystoscopy model). Self-assessment measures included MUS-related visual analog scale (VAS), Likert, and open-ended questions. Objective assessment measures were used to score blinded videos of trocar passage on a pelvic model, including a modified objective structured assessment of technical skills (mOSAT) and a retropubic MUS-specific checklist of surgical steps. Emerging themes from the open-ended questions were identified using grounded theory; analysis ceased once theme saturation was achieved.ResultsTwenty-five of 37 total residents participated in the training session and 24 participated in this study. Following training, VAS scores, Likert scores, and qualitative analysis indicated greater resident comfort with performing retropubic MUS, with relevant anatomy, and with trocar passage. Residents demonstrated improvement in model trocar passage post-training, with a rise in mOSAT score (47% to 65%; p = .01) and a rise in checklist score (61% to 75%; p = .11). Residents expressed discomfort due to inexperience with MUS, concern regarding trocar passage, and worry over potential complications. Residents reported feeling more prepared to perform MUS after the session. They stressed the importance of repetition and a comfortable learning environment for surgical training, and praised the “hands-on” training session.ConclusionWe demonstrate success using a short, single-session, hands-on group training session to improve comfort and skill with retropubic MUS.
Highlights
Surgical simulation is a valid and increasingly popular method to teach surgical skills [1,2,3]
Residents demonstrated improvement in model trocar passage post-training, with a rise in modified objective structured assessment of technical skills (mOSAT) score (47% to 65%; p = .01) and a rise in checklist score (61% to 75%; p = .11)
Gynecologic surgical training using simulation to afford maximum learning during surgical cases is increasingly relevant as trainee work hours decline and hospitals focus on reducing operating room times
Summary
Surgical simulation is a valid and increasingly popular method to teach surgical skills [1,2,3]. Use of a simulation model and the presentation of focused content knowledge prior to real-life surgery provides an opportunity for early surgical skill acquisition, allowing the trainee to focus on higher level skills during subsequent intra-operative experiences [4]. Gynecologic surgical training using simulation to afford maximum learning during surgical cases is increasingly relevant as trainee work hours decline and hospitals focus on reducing operating room times. The goal of this study was to introduce a cadaver and model-based teaching program to our residents and measure its impact on resident comfort and skill with passage of retropubic trocars in a MUS model
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