Cervical cerclage training: Development and assessment of a simulator.

cervical cerclage cervical stitch high-risk pregnancy obstetrics operative training preterm birth simulation surgical skills training

Journal

American journal of obstetrics & gynecology MFM
ISSN: 2589-9333
Titre abrégé: Am J Obstet Gynecol MFM
Pays: United States
ID NLM: 101746609

Informations de publication

Date de publication:
03 2023
Historique:
received: 13 10 2022
revised: 25 11 2022
accepted: 26 12 2022
pubmed: 2 1 2023
medline: 3 3 2023
entrez: 1 1 2023
Statut: ppublish

Résumé

Cervical cerclage is a mainstay intervention for the prevention of spontaneous preterm birth in high-risk women. Simulation training facilitates high-level skill transfer in a low-consequence environment, and is being integrated into obstetrics and gynecology training. This study aimed to develop a simulator for cervical cerclage, determine its validity as a simulator, and identify parameters suitable as proxy markers for performance. The 3 aims of this study were achieved, namely: (1) simulator design by obstetricians and a commercial company; (2) survey of obstetricians and gynecologists across a variety of training stages to determine need for and opinion of the simulator; and (3) comparison of novice and expert groups across a variety of proxy markers for successful cerclage insertion. Obstetricians and gynecologists found the simulator to be similar to clinical scenarios and suitable for skill training. Novice participants stated that the use of the simulator improved their confidence (P=.016). In a comparison between 6 expert and 8 novice surgeons, there seemed to be variations across multiple measurements of cerclage placement. Simulation is an increasingly prominent training modality for surgical skills. The simulator described herein was considered suitable for training by obstetricians and gynecologists. Further work should focus on the validations of proxy markers of successful insertion, longitudinal assessment of trainees, and correlation of training outcomes with clinical outcomes.

Sections du résumé

BACKGROUND
Cervical cerclage is a mainstay intervention for the prevention of spontaneous preterm birth in high-risk women. Simulation training facilitates high-level skill transfer in a low-consequence environment, and is being integrated into obstetrics and gynecology training.
OBJECTIVE
This study aimed to develop a simulator for cervical cerclage, determine its validity as a simulator, and identify parameters suitable as proxy markers for performance.
STUDY DESIGN
The 3 aims of this study were achieved, namely: (1) simulator design by obstetricians and a commercial company; (2) survey of obstetricians and gynecologists across a variety of training stages to determine need for and opinion of the simulator; and (3) comparison of novice and expert groups across a variety of proxy markers for successful cerclage insertion.
RESULTS
Obstetricians and gynecologists found the simulator to be similar to clinical scenarios and suitable for skill training. Novice participants stated that the use of the simulator improved their confidence (P=.016). In a comparison between 6 expert and 8 novice surgeons, there seemed to be variations across multiple measurements of cerclage placement.
CONCLUSION
Simulation is an increasingly prominent training modality for surgical skills. The simulator described herein was considered suitable for training by obstetricians and gynecologists. Further work should focus on the validations of proxy markers of successful insertion, longitudinal assessment of trainees, and correlation of training outcomes with clinical outcomes.

Identifiants

pubmed: 36587806
pii: S2589-9333(22)00283-X
doi: 10.1016/j.ajogmf.2022.100853
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

100853

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Megan Hall (M)

Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, United Kingdom (Drs Hall and Suff, Mses Coary, Abernethy, and Debray, and Dr Shennan); Department of Perinatal Imaging and Health, St Thomas' Hospital, King's College London, London, United Kingdom (Dr Hall). Electronic address: megan.hall@kcl.ac.uk.

Natalie Suff (N)

Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, United Kingdom (Drs Hall and Suff, Mses Coary, Abernethy, and Debray, and Dr Shennan).

Laura Stirrat (L)

Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (Dr Stirrat).

Carrie Coary (C)

Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, United Kingdom (Drs Hall and Suff, Mses Coary, Abernethy, and Debray, and Dr Shennan).

Jessie Abernethy (J)

Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, United Kingdom (Drs Hall and Suff, Mses Coary, Abernethy, and Debray, and Dr Shennan).

Raphaelle Debray (R)

Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, United Kingdom (Drs Hall and Suff, Mses Coary, Abernethy, and Debray, and Dr Shennan).

Graham Tydeman (G)

NHS Fife, Kirkcaldy, United Kingdom (Dr Tydeman).

Andrew Shennan (A)

Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, United Kingdom (Drs Hall and Suff, Mses Coary, Abernethy, and Debray, and Dr Shennan).

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Classifications MeSH