Comparative Effectiveness of Teaching Obstetrics and Gynaecological Procedural Skills on Patients versus Models: A randomized trial

Abstract

Objective:To compare the effectiveness of learning procedural skills on patients versus mannequins and models.Methods:Seventy four interns from two consecutive batches at the Department of Obstetrics and Gynaecolgy Unit-I at Jinnah Postgraduate Medical Center Karachi participated in the study between April and September 2014. Five basic skills; taking a cervical (Pap) smear, intrauterine contraceptive device insertion, manual vacuum aspiration, making/ suturing an episiotomy and active management of the third stage of labour were identified. Interns were randomly allocated to two training groups (Group-1 and 2 of thirty eight and thirty six trainees respectively), with Group-I received training on the five procedural skills on models and mannequins for four weeks while Group-II trained on patients initially. After an evaluation at four weeks the groups crossed over with a final evaluation at eight weeks. The evaluation was through identical objective structured assessment of technical skills on models and mannequins for both groups with standard checklists.Results:There was no significant difference in skills between the two groups at the four weeks assessment. However at the end of training, Group-1 trainees performed significantly better than Group 2 with higher overall tests scores (86.7 ± 2.7 versus 80.4 ± 4.8, p< 0.001). This difference was more marked in skills of intrauterine contraceptive device insertion, making and suturing an episiotomy and active management of third stage of labour.Conclusion:Our findings suggest that simulations using models and mannequins for developing procedural skills can be readily incorporated in training programs with potential benefits for teaching infrequently performed or more difficult procedures. Our data suggest potential benefits of initiation of trainings on simulations and mannequins followed by human subject exposure.

Effects of Virtual Reality training on medical students’ learning motivation and competency

“…No comparative study was conducted for the efficiency, effectiveness and acceptability of the virtual reality in medical. No study explained the adaptability of routine use of simulation environment 18…”

Blended Teaching Methodology of E-learning and Simulation Training in Obstetrics and Gynecology for Undergraduate Medical and Nursing Trainees

“…The students strongly felt that newer teaching methodologies should replace conventional classroom lectures. A recent randomized trial [15] compared the efficacy of two teaching strategies on skill learning in medical students during internship and concluded that training is better if done on mannequins prior to patients. Similar experiences had been reported by first-year nursing students who had undergone highfidelity simulation learning in Japan [16].…”

Real Time, Remote, and Recorded: Medical Student Experiences with Smart Glasses in Obstetrical Simulation

“…3 Evidence specifically from Obstetrics and Gynecology, a field with unique barriers to trainee exposure and practice, suggests that trainees who use simulation training models to practice gynecological procedural skills can develop similar competencies compared with in-person training and can be used as an initiation platform for teaching infrequently performed procedures. 4 Using newer technology such as telemedicine in simulationbased training presents a feasible solution in the pandemic era. Traditional telemedicine approaches, such as recorded videos and live teleconferencing, have limited utility in procedural and surgical applications, providing little opportunity to interact and supervise the trainee during the activity.…”

“…There is increasing evidence to suggest that simulation-based training in health care improves patient outcomes 3 . Evidence specifically from Obstetrics and Gynecology, a field with unique barriers to trainee exposure and practice, suggests that trainees who use simulation training models to practice gynecological procedural skills can develop similar competencies compared with in-person training and can be used as an initiation platform for teaching infrequently performed procedures 4 …”