Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial
Abstract Introduction Vaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present st...
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| Language: | English |
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Wiley
2024-06-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14810 |
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| author | Roxana Geoffrion Nicole A. Koenig Geoffrey W. Cundiff Catherine Flood Momoe T. Hyakutake Jane Schulz Erin A. Brennand Terry Lee Joel Singer Nicole J. Todd |
| author_facet | Roxana Geoffrion Nicole A. Koenig Geoffrey W. Cundiff Catherine Flood Momoe T. Hyakutake Jane Schulz Erin A. Brennand Terry Lee Joel Singer Nicole J. Todd |
| author_sort | Roxana Geoffrion |
| collection | DOAJ |
| description | Abstract Introduction Vaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present study was to investigate whether procedure‐specific simulation skills, vs usual training, result in improved operative competence. Material and methods We completed a randomized controlled trial of didactic and procedural training via low fidelity vaginal surgery models for anterior repair, posterior repair (PR), vaginal hysterectomy (VH), recruiting novice gynecology residents at three academic centers. We evaluated performance via global rating scale (GRS) in the real operating room and for corresponding procedures by attending surgeon blinded to group. Prespecified secondary outcomes included procedural steps knowledge, overall performance, satisfaction, self‐confidence and intraoperative parameters. A priori sample size estimated 50 residents (20% absolute difference in GRS score, 25% SD, 80% power, alpha 0.05). Clinicaltrials.gov: Registration no. NCT05887570. Results We randomized 83 residents to intervention or control and 55 completed the trial (2011–23). Baseline characteristics were similar, except for more fourth‐year control residents. After adjustment of confounders (age, level, baseline knowledge), GRS scores showed significant differences overall (mean difference 8.2; 95% confidence interval [CI]: 0.2–16.1; p = 0.044) and for VH (mean difference 12.0; 95% CI: 1.8–22.3; p = 0.02). The intervention group had significantly higher procedural steps knowledge and self‐confidence for VH and/or PR (p < 0.05, adjusted analysis). Estimated blood loss, operative time and complications were similar between groups. Conclusions Compared to usual training, procedure‐specific didactic and low fidelity simulation modules for vaginal surgery resulted in significant improvements in operative performance and several other skill parameters. |
| format | Article |
| id | doaj-art-4ca8f792bc1349d4a70b97ddcb6d7306 |
| institution | DOAJ |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-4ca8f792bc1349d4a70b97ddcb6d73062025-08-20T03:22:16ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-06-0110361165117410.1111/aogs.14810Procedure‐specific simulation for vaginal surgery training: A randomized controlled trialRoxana Geoffrion0Nicole A. Koenig1Geoffrey W. Cundiff2Catherine Flood3Momoe T. Hyakutake4Jane Schulz5Erin A. Brennand6Terry Lee7Joel Singer8Nicole J. Todd9Division of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia Vancouver British Columbia CanadaDivision of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia Vancouver British Columbia CanadaDivision of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia Vancouver British Columbia CanadaDivision of Urogynecology, Department of Obstetrics and Gynecology University of Alberta Edmonton Alberta CanadaDivision of Urogynecology, Department of Obstetrics and Gynecology University of Alberta Edmonton Alberta CanadaDivision of Urogynecology, Department of Obstetrics and Gynecology University of Alberta Edmonton Alberta CanadaDivision of Urogynecology, Department of Obstetrics and Gynecology University of Calgary Calgary Alberta CanadaCentre for Advancing Health Outcomes Vancouver British Columbia CanadaCentre for Advancing Health Outcomes Vancouver British Columbia CanadaDivision of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia Vancouver British Columbia CanadaAbstract Introduction Vaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present study was to investigate whether procedure‐specific simulation skills, vs usual training, result in improved operative competence. Material and methods We completed a randomized controlled trial of didactic and procedural training via low fidelity vaginal surgery models for anterior repair, posterior repair (PR), vaginal hysterectomy (VH), recruiting novice gynecology residents at three academic centers. We evaluated performance via global rating scale (GRS) in the real operating room and for corresponding procedures by attending surgeon blinded to group. Prespecified secondary outcomes included procedural steps knowledge, overall performance, satisfaction, self‐confidence and intraoperative parameters. A priori sample size estimated 50 residents (20% absolute difference in GRS score, 25% SD, 80% power, alpha 0.05). Clinicaltrials.gov: Registration no. NCT05887570. Results We randomized 83 residents to intervention or control and 55 completed the trial (2011–23). Baseline characteristics were similar, except for more fourth‐year control residents. After adjustment of confounders (age, level, baseline knowledge), GRS scores showed significant differences overall (mean difference 8.2; 95% confidence interval [CI]: 0.2–16.1; p = 0.044) and for VH (mean difference 12.0; 95% CI: 1.8–22.3; p = 0.02). The intervention group had significantly higher procedural steps knowledge and self‐confidence for VH and/or PR (p < 0.05, adjusted analysis). Estimated blood loss, operative time and complications were similar between groups. Conclusions Compared to usual training, procedure‐specific didactic and low fidelity simulation modules for vaginal surgery resulted in significant improvements in operative performance and several other skill parameters.https://doi.org/10.1111/aogs.14810gynecologic surgerylow fidelity simulationsurgical educationvaginal hysterectomy |
| spellingShingle | Roxana Geoffrion Nicole A. Koenig Geoffrey W. Cundiff Catherine Flood Momoe T. Hyakutake Jane Schulz Erin A. Brennand Terry Lee Joel Singer Nicole J. Todd Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial Acta Obstetricia et Gynecologica Scandinavica gynecologic surgery low fidelity simulation surgical education vaginal hysterectomy |
| title | Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial |
| title_full | Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial |
| title_fullStr | Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial |
| title_full_unstemmed | Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial |
| title_short | Procedure‐specific simulation for vaginal surgery training: A randomized controlled trial |
| title_sort | procedure specific simulation for vaginal surgery training a randomized controlled trial |
| topic | gynecologic surgery low fidelity simulation surgical education vaginal hysterectomy |
| url | https://doi.org/10.1111/aogs.14810 |
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