Comparison of 2 Simulation Models for Teaching Obstetric Anal Sphincter Repair

Dancz, Christina E.; Sun, Vanessa; Moon, Hannah B.; Chen, Judy H.; Özel, Begüm

doi:10.1097/sih.0000000000000043

Cited by 22 publications

(20 citation statements)

References 16 publications

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“…6 In comparison, the beef tongue model more closely replicates the feel of perineal tissue and is preferred by OB/GYN residents. 7 Furthermore, the more-advanced beef tongue preparations allow for the simulation of all anatomic findings in real OASIS. 5,8 However, the beef tongue model is expensive and time consuming to prepare and cannot accommodate learners with religious or moral objections to meat products.…”

Section: Introductionmentioning

confidence: 99%

Perineal Laceration and Episiotomy Repair Using a Beef Tongue Model

et al. 2020

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Introduction: Declining rates of operative vaginal deliveries and routine episiotomy in obstetric practice, along with rising cesarean section rates, have decreased OB/GYN resident experience with episiotomy repair and obstetric anal sphincter injuries (OASIS). Simulation models are valuable educational tools in procedural training. Several models have been reported, each with its own limitations and benefits. Methods: We developed a 1-hour workshop to teach novice OB/GYN residents perineal laceration repair skills on a modified beef tongue model. The model required 5-10 minutes to assemble following written and video instruction, and learners had 30-50 minutes to practice using learner instructions. Learners were evaluated using a procedure checklist and global objective structured assessment of technical skills. To evaluate the session, we surveyed current faculty and residents, as well as residency graduates. Results: Between 2008 and 2017, an estimated 82 OB/GYN residents participated in this activity, and 95 participants and facilitators received the survey. Forty-one (59%) respondents agreed that this model was similar to repairing OASIS in clinical practice. Our trainees reported that the optimal time for simulated OASIS repair was the R2 and R3 years; however, 90% of respondents felt residents should be offered this simulation yearly. Discussion: Based on our survey of trainees, graduates, and faculty, we created a realistic simulated OASIS repair training, despite the limitation that the model lacked a rectum. Learners reported an interest in repeating the simulation frequently during residency to augment their clinical experience and increase perceived competence in third-and fourth-degree laceration repair by their graduation.

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Section: Introductionmentioning

confidence: 99%

Perineal Laceration and Episiotomy Repair Using a Beef Tongue Model

et al. 2020

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“…The beef tongue specimens were purchased from Tianjin Jingdong Daye Trading Co. LTD.Training boxes were covered with a 2 cm-thick silica gel to simulate the abdominal wall. In agreement with other in vitro studies [8,9], the beef tongue specimens was cut into 400 g sections. Pieces were morcellated in the tissue containment system and dyed with 5 ml of methylene blue solution to aid leakage detection.…”

Section: Methodsmentioning

confidence: 82%

Risk of leakage with a new detachable multi-hard-port containment system for power morcellation during gynecologic laparoscopy: An in vitro study

Fang

Wang

Ling

et al. 2023

Preprint

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Although laparoscopic surgery has been a milestone for minimally invasive surgeries, there still exists concern of the spread of morcellated tissue fragments in malignancy. Different tissue containment systems have been used in laparoscopic power morcellation. However, a risk of leakage still exists in clinical practice.In this study, we aimed to evaluate leakage and tissue dissemination associated with a new detachable multi-hard-port containment system for tissue removal during laparoscopic myomectomy morcellation. Beef tongue specimens were stained with indigo carmine dye and morcellated under laparoscopic guidance in a plastic trainer box. The morcellation test in in vitro conditions comprised two different containment systems to simulate laparoscopic power morcellation, specifically a polyurethane bag with two pipes (control group) and a detachable multi-hard-port containment system (experimental group). Insufflation pressure was set at 14 mmHg. Visual evidence of spilled tissue or dye and procedure times were recorded. Thirty trials were performed using a multi-port approach and the two tissue containment systems. The leakage rate was 0.03% (n = 30) for the experimental group and 26.6% (n = 30) for the control group (p < 0.005). Morcellation time was significantly shorter in the experimental group than that in the control group (p < 0.001). Median bag introduction time was shorter in the experimental group than that in the control group; however, removal time differences were not significant. This study quantified leakage during morcellation and the convenience provided by a new tissue containment system.

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“…As simulation becomes increasingly important in medical education, particularly for 3 rd and 4 th -degree laceration repair, this model could be a valuable adjunctive curricular component. Several studies have evaluated models for teaching obstetric anal sphincter injury repair and have found improvements in resident skill sets after undergoing an educational workshop [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Obstetrics and gynecology residents’ satisfaction and self-confidence after an anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study

Wahyuningtyas

Kurniawati

Utomo

et al. 2022

J Educ Eval Health Prof

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Purpose: Obstetric anal sphincter injury (OASI) is one of the most common complication during delivery. Simulation models using manikin can be used as an effective medical learning method to improve students’ abilities before meeting patients. It aimed to describe the development of anal sphincter injury model and assess the resident satisfaction and self-confidence after perineal repair workshop with anal sphincter injury simulator in Indonesia.Methods: This was cross-sectional study with evaluation of outcome before and after workshop. We created silicone-latex simulation anal sphincter injury model. Then, we validated this simulation and made it as simulation model for workshop. We asked residents’ satisfaction repairing anal sphincter injury using simulation model and residents’ self-confidence when practicing the anal sphincter injury repair. Results: All residents felt the simulation-based workshop was valuable (100%). Most of score for similarity simulation model were good (about 8). The self-assessment of confidence was measured prior to the workshop and after the workshop. The overall self-confidence was increased significantly after workshop in procedure identification external sphincter ani (EAS) (P=0.031), suturing anal mucosa (P=0.001), suturing internal sphincter ani (P=0.001), suturing external sphincter ani (EAS) (P <0.001), evaluation of sphincter ani tone (P=0.016). Conclusion: Anal sphincter injury simulator improves the self-confidence of residents in procedure identification external sphincter ani (EAS), suturing anal mucosa, suturing internal sphincter ani, suturing external sphincter ani (EAS) and evaluation of sphincter ani tone.

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Comparison of 2 Simulation Models for Teaching Obstetric Anal Sphincter Repair

Cited by 22 publications

References 16 publications

Perineal Laceration and Episiotomy Repair Using a Beef Tongue Model

Perineal Laceration and Episiotomy Repair Using a Beef Tongue Model

Risk of leakage with a new detachable multi-hard-port containment system for power morcellation during gynecologic laparoscopy: An in vitro study

Obstetrics and gynecology residents’ satisfaction and self-confidence after an anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study

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