Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents
Introduction The future of training in second trimester surgical abortions with dilation and evacuation (D&E) procedures faces ongoing legal and political scrutiny; thus, adjuncts to standard clinical experiences are exceedingly important. We sought to build medical trainees’ surgical familiarit...
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Association of American Medical Colleges
2025-01-01
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| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.11489 |
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| author | Kiley Hunkler David Boedeker Elizabeth Gill Katelyn Simpkins Katerina Shvartsman Jill Brown Sara Drayer |
| author_facet | Kiley Hunkler David Boedeker Elizabeth Gill Katelyn Simpkins Katerina Shvartsman Jill Brown Sara Drayer |
| author_sort | Kiley Hunkler |
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| description | Introduction The future of training in second trimester surgical abortions with dilation and evacuation (D&E) procedures faces ongoing legal and political scrutiny; thus, adjuncts to standard clinical experiences are exceedingly important. We sought to build medical trainees’ surgical familiarity with D&Es using a realistic simulation model. Methods The simulation began with an instructional video reviewing accessible and affordable materials used to build the fetal model (vaginal swabs, styrofoam ball, and putty) and the uterine model (collapsible water bottle). Required personnel roles included surgeon, surgical assistant, and facilitator. A standardized rubric was used to evaluate learners’ mastery of procedural learning objectives, and a pre- and postsimulation assessment measured learners’ knowledge and confidence before and after the activity. Consistency between iterations was maintained with use of standardized prompts and lectures. Total time for the activity, including setup and debrief, was 1 hour. Results Eighteen residents, medical students, and attendings participated in the simulation, and 100% completed the assessment. There was a demonstrated improvement in clinical knowledge of D&E steps (56% presimulation vs. 94% postsimulation, p < .001) and increased surgical confidence in performing D&Es after participating in the simulation (28% presimulation vs. 89% postsimulation, p < .001). The participants with prior clinical experience in performing D&Es rated the fetal, uterine, and cervical models as realistic components in the simulation. Discussion A gap now exists in access to clinical D&E training. This low-fidelity D&E simulation is a training tool that can fill this gap and improve learners’ familiarity with this surgical procedure. |
| format | Article |
| id | doaj-art-092923291e6349069fef035fdfff3876 |
| institution | Kabale University |
| issn | 2374-8265 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj-art-092923291e6349069fef035fdfff38762025-01-21T05:00:11ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652025-01-012110.15766/mep_2374-8265.11489Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics ResidentsKiley Hunkler0David Boedeker1Elizabeth Gill2Katelyn Simpkins3Katerina Shvartsman4Jill Brown5Sara Drayer6Fellow, Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical Center; Fellow, Reproductive Endocrinology and Infertility, National Institute of Child Health and Human Development, National Institutes of HealthFourth-Year Resident, Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical CenterSecond-Year Resident, Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical CenterThird-Year Resident, Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical CenterAssociate Professor, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences F. Edward Hébert School of MedicineAssociate Professor, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences F. Edward Hébert School of MedicineFellow, Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical CenterIntroduction The future of training in second trimester surgical abortions with dilation and evacuation (D&E) procedures faces ongoing legal and political scrutiny; thus, adjuncts to standard clinical experiences are exceedingly important. We sought to build medical trainees’ surgical familiarity with D&Es using a realistic simulation model. Methods The simulation began with an instructional video reviewing accessible and affordable materials used to build the fetal model (vaginal swabs, styrofoam ball, and putty) and the uterine model (collapsible water bottle). Required personnel roles included surgeon, surgical assistant, and facilitator. A standardized rubric was used to evaluate learners’ mastery of procedural learning objectives, and a pre- and postsimulation assessment measured learners’ knowledge and confidence before and after the activity. Consistency between iterations was maintained with use of standardized prompts and lectures. Total time for the activity, including setup and debrief, was 1 hour. Results Eighteen residents, medical students, and attendings participated in the simulation, and 100% completed the assessment. There was a demonstrated improvement in clinical knowledge of D&E steps (56% presimulation vs. 94% postsimulation, p < .001) and increased surgical confidence in performing D&Es after participating in the simulation (28% presimulation vs. 89% postsimulation, p < .001). The participants with prior clinical experience in performing D&Es rated the fetal, uterine, and cervical models as realistic components in the simulation. Discussion A gap now exists in access to clinical D&E training. This low-fidelity D&E simulation is a training tool that can fill this gap and improve learners’ familiarity with this surgical procedure.http://www.mededportal.org/doi/10.15766/mep_2374-8265.11489Abortion AccessAbortion TrainingDilation and EvacuationGynecologic SurgeryWomen's HealthClinical/Procedural Skills Training |
| spellingShingle | Kiley Hunkler David Boedeker Elizabeth Gill Katelyn Simpkins Katerina Shvartsman Jill Brown Sara Drayer Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents MedEdPORTAL Abortion Access Abortion Training Dilation and Evacuation Gynecologic Surgery Women's Health Clinical/Procedural Skills Training |
| title | Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents |
| title_full | Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents |
| title_fullStr | Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents |
| title_full_unstemmed | Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents |
| title_short | Second Trimester Abortion: A Dilation and Evacuation Simulation for Gynecologic Surgery and Obstetrics Residents |
| title_sort | second trimester abortion a dilation and evacuation simulation for gynecologic surgery and obstetrics residents |
| topic | Abortion Access Abortion Training Dilation and Evacuation Gynecologic Surgery Women's Health Clinical/Procedural Skills Training |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.11489 |
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