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Vaginal Hysterectomy Suturing Skills Training Model and Curriculum

Balgobin, Sunil MD; Owens, David M. MD; Florian-Rodriguez, Maria E. MD; Wai, Clifford Y. MD; McCord, Eddie H. MD; Hamid, Cherine A. MD

doi: 10.1097/AOG.0000000000003420
Contents: Medical Education: Procedures and Instruments
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BACKGROUND: Declining vaginal hysterectomy numbers in obstetrics and gynecology training programs highlights the need for innovative methods to teach vaginal surgical skills. We describe our experience with a vaginal hysterectomy skills simulation curriculum.

INSTRUMENT: A low-fidelity bench model was constructed to simulate four vaginal hysterectomy suturing tasks. A polyvinyl chloride downspout adapter and low-cost materials simulate the Heaney pedicle stitch, simple pedicle stitch, double ligature, and continuous running stitch.

EXPERIENCE: Faculty expert vaginal surgeons established proficiency levels for each task. Resident (N=30) pass rates for tasks 1, 2, and 3 were 1 of 30 (3.3%), 7 of 30 (23.3%), and 4 of 30 (13.3%), respectively, for the left side, and 3 of 30 (10%), 9 of 30 (30%), and 10 of 30 (33.3%), respectively, for the right side. For task 4, the pass rate was 14 of 30 (46.7%). The majority of residents felt that the model simulates the technical skills required for vaginal hysterectomy and agreed that vaginal skills laboratory training would improve their ability to perform procedures in the operating room. Ninety-two percent of residents felt that a vaginal surgery skills curriculum would be a useful addition to their simulation education.

CONCLUSION: A proficiency-based vaginal hysterectomy skills simulation curriculum using a low-fidelity model may be an important training and evaluation tool for vaginal surgical skills training.

A vaginal hysterectomy skills simulation curriculum using a low-fidelity model may enhance vaginal surgical training in residency.

Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.

Corresponding author: Sunil Balgobin, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX; email: sunil.balgobin@utsouthwestern.edu.

Supported by the University of Texas Southwestern Academy of Teachers (SWAT) Educational Grants Program.

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank Chris Caudle, BA, for assistance with video production and editing.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews are available at http://links.lww.com/AOG/B490.

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.