Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care

Introduction In the US, one in four women will have an abortion, and most OB/GYN physicians have had patients who required abortion care. Most second-trimester abortions in the US (95%) are performed via dilation and evacuation (D&E), which requires provider skill and competency. Barriers to obt...

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Main Authors: Haven Frazier, Leanne Free, Shana Miles, Matthew Vanbaaren, Adam Levy
Format: Article
Language:English
Published: Association of American Medical Colleges 2025-05-01
Series:MedEdPORTAL
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Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.11525
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author Haven Frazier
Leanne Free
Shana Miles
Matthew Vanbaaren
Adam Levy
author_facet Haven Frazier
Leanne Free
Shana Miles
Matthew Vanbaaren
Adam Levy
author_sort Haven Frazier
collection DOAJ
description Introduction In the US, one in four women will have an abortion, and most OB/GYN physicians have had patients who required abortion care. Most second-trimester abortions in the US (95%) are performed via dilation and evacuation (D&E), which requires provider skill and competency. Barriers to obtaining abortion training include opt-in residency programs, location-based legal restrictions, and religiously affiliated institutions. Our D&E simulation is a cost-effective, realistic model. Methods D&E models were assembled using juice containers, Cornish hens, and Sopher forceps. Thirty-five participants (medical students and OB/GYN residents) completed presimulation surveys and received a brief lecture about abortion demographics, techniques, and complications, followed by the hands-on simulation; 27 completed postsimulation surveys. Participants assessed their comfort levels in performing D&Es and recognizing postabortion complications, and their likelihood of performing D&Es in future clinical practice. Results Comfort levels significantly improved pre- to postsimulation, increasing from 32% to 55% (p < .001) for participants reporting feeling somewhat comfortable or extremely comfortable performing D&Es, and increasing from 46% to 63% (p < .01) for participants reporting feeling somewhat comfortable or extremely comfortable recognizing postabortion complications after receiving the introductory lecture. Overall, participants indicated that the simulation was realistic (92%) and increased their knowledge (100%) and ability to perform D&Es (96%). Discussion Our affordable and simple D&E model can be easily replicated and implemented for training in second-trimester D&E. This model can serve as a valuable and realistic tool for providers with restricted access to clinical abortion who need adjunct training, improving physician education and competency.
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spelling doaj-art-b9d81042232243f5ade81ddf4be996f12025-08-20T02:56:09ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652025-05-012110.15766/mep_2374-8265.11525Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion CareHaven Frazier0Leanne Free1Shana Miles2Matthew Vanbaaren3Adam Levy4Fourth-Year Resident, Department of Gynecologic Surgery and Obstetrics, Kirk Kerkorian School of Medicine at UNLV and Nellis Air Force BaseAssistant Professor, Department of Gynecologic Surgery and Obstetrics, Kirk Kerkorian School of Medicine at UNLVAssociate Professor, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine and Nellis Air Force BaseFirst-Year Resident, Department of Gynecologic Surgery and Obstetrics, Kirk Kerkorian School of Medicine at UNLVAssociate Professor, Department of Gynecologic Surgery and Obstetrics, Kirk Kerkorian School of Medicine at UNLVIntroduction In the US, one in four women will have an abortion, and most OB/GYN physicians have had patients who required abortion care. Most second-trimester abortions in the US (95%) are performed via dilation and evacuation (D&E), which requires provider skill and competency. Barriers to obtaining abortion training include opt-in residency programs, location-based legal restrictions, and religiously affiliated institutions. Our D&E simulation is a cost-effective, realistic model. Methods D&E models were assembled using juice containers, Cornish hens, and Sopher forceps. Thirty-five participants (medical students and OB/GYN residents) completed presimulation surveys and received a brief lecture about abortion demographics, techniques, and complications, followed by the hands-on simulation; 27 completed postsimulation surveys. Participants assessed their comfort levels in performing D&Es and recognizing postabortion complications, and their likelihood of performing D&Es in future clinical practice. Results Comfort levels significantly improved pre- to postsimulation, increasing from 32% to 55% (p < .001) for participants reporting feeling somewhat comfortable or extremely comfortable performing D&Es, and increasing from 46% to 63% (p < .01) for participants reporting feeling somewhat comfortable or extremely comfortable recognizing postabortion complications after receiving the introductory lecture. Overall, participants indicated that the simulation was realistic (92%) and increased their knowledge (100%) and ability to perform D&Es (96%). Discussion Our affordable and simple D&E model can be easily replicated and implemented for training in second-trimester D&E. This model can serve as a valuable and realistic tool for providers with restricted access to clinical abortion who need adjunct training, improving physician education and competency.http://www.mededportal.org/doi/10.15766/mep_2374-8265.11525AbortionDilation and EvacuationOB/GYNSimulationWomen's HealthClinical/Procedural Skills Training
spellingShingle Haven Frazier
Leanne Free
Shana Miles
Matthew Vanbaaren
Adam Levy
Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care
MedEdPORTAL
Abortion
Dilation and Evacuation
OB/GYN
Simulation
Women's Health
Clinical/Procedural Skills Training
title Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care
title_full Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care
title_fullStr Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care
title_full_unstemmed Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care
title_short Dilation and Evacuation Simulation Model for Learners and Providers Who Offer Abortion Care
title_sort dilation and evacuation simulation model for learners and providers who offer abortion care
topic Abortion
Dilation and Evacuation
OB/GYN
Simulation
Women's Health
Clinical/Procedural Skills Training
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.11525
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