ACOG Simulation Working Group: A Needs Assessment of Simulation Training in OB/GYN Residencies and Recommendations for Future Research

Christopher C DeStephano; Joshua F Nitsche; Michael G Heckman; Erika Banks; Hye-Chun Hur

doi:10.1016/j.jsurg.2019.12.002

ACOG Simulation Working Group: A Needs Assessment of Simulation Training in OB/GYN Residencies and Recommendations for Future Research

J Surg Educ. 2020 May-Jun;77(3):661-670. doi: 10.1016/j.jsurg.2019.12.002. Epub 2019 Dec 16.

Authors

Christopher C DeStephano¹, Joshua F Nitsche², Michael G Heckman³, Erika Banks⁴, Hye-Chun Hur⁵

Affiliations

¹ Mayo Clinic Department of Surgical Gynecology, Jacksonville, Florida. Electronic address: Destephano.christopher@mayo.edu.
² Wake Forest School of Medicine Department of OB/GYN, Winston-Salem, North Carolina.
³ Mayo Clinic Department of Surgical Gynecology, Jacksonville, Florida; Mayo Clinic Division of Biomedical Statistics and Informatics, Jacksonville, Florida.
⁴ Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, New York, New York.
⁵ Division of Gynecologic Specialty Surgery, Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York.

PMID: 31859227
DOI: 10.1016/j.jsurg.2019.12.002

Abstract

Objective: To evaluate current availability and needs of simulation training among obstetrics/gynecology (OB/GYN) residency programs.

Design: Cross-sectional survey.

Setting: Accreditation Council for Graduate Medical Education accredited OB/GYN residency programs in the United States.

Participants: Residency program directors, gynecology simulation faculty, obstetrics simulation faculty, and fourth-year residents.

Results: Of 673 invited participants, 251 (37.3%) completed the survey. Among the survey responses, OB procedures were more broadly represented compared to the GYN procedures for simulation teaching: 8 (50%) of 16 OB procedures versus 4 (18.2%) of 22 GYN procedures had simulation teaching. Among the simulated procedures, a majority of residents and faculty reported that simulation teaching was available for operative vaginal delivery, postpartum hemorrhage, shoulder dystocia, perineal laceration repair, conventional laparoscopic procedures, and robotic surgery. There were significant differences between residents and faculty perceptions regarding the availability and needs of simulated procedures with a minority of residents having knowledge of Council on Resident Education in Obstetrics and Gynecology (47.2%) and American College of Obstetrics and Gynecology (27.8%) simulation tools compared to the majority of faculty (84.7% and 72.1%, respectively). More than 80% of trainees and faculty reported they felt the average graduating resident could perform vaginal, laparoscopic, and abdominal hysterectomies independently.

Conclusions: Simulation is now widely available for both gynecologic and obstetric procedures, but there remains tremendous heterogeneity between programs and the perceptions of residents, program directors, and faculty. The variations in simulation training and readiness for performing different procedures following residency support the need for objective, validated assessments of actual performance to better guide resident learning and faculty teaching efforts.

Keywords: gynecology; needs assessment; obstetrics; surgical performance; surgical simulation.

MeSH terms

Cross-Sectional Studies
Curriculum
Female
Gynecology* / education
Humans
Internship and Residency*
Needs Assessment
Obstetrics* / education
Pregnancy
Simulation Training*
Surveys and Questionnaires
United States