Improving Resident Competence and Knowledge Regarding Tension-Free Vaginal Tape Procedure

Sabourin, Jeanelle; Schulz, Jane; Flood, Cathy

doi:10.1097/spv.0b013e31825e63ed

Cited by 9 publications

(7 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are discordant with previous studies showing that novice surgeons seem to benefit from review of relevant anatomy, using either a model 13 or video demonstration, 11,12 and practice of TVT trocar passage 12,13 . Sabourin et al 12 used a training model similar to ours consisting of watching the manufacturer video for the TVT and subsequently simulating trocar passage with a sling trainer, leading to improvement in written examination results and self-assessment scores. When surveyed about intraoperative teaching methods, residents have placed higher value on teachers who identified anatomic landmarks, used perceptual motor teaching, and encouraged repetition 11 .…”

Section: Discussionsupporting

confidence: 71%

“…Although several animal and simulation models have been suggested, there are no data linking these methods to clinical outcomes and thus, limited evidence to support their efficacy. [11][12][13] At our teaching institution, the majority of resident surgical training occurs via direct instruction in the operating room by an attending and/or fellow surgeon, without formal preoperative instruction or simulation. Residents are expected to prepare for cases independently, but self-directed learning may be limited due to lack of a structured curriculum and long work hours.…”

Section: Why This Mattersmentioning

confidence: 99%

“…The literature describing methods to teach residents the skills required for successful midurethral sling placement is meager. Although several animal and simulation models have been suggested, there are no data linking these methods to clinical outcomes and thus, limited evidence to support their efficacy 11–13 . At our teaching institution, the majority of resident surgical training occurs via direct instruction in the operating room by an attending and/or fellow surgeon, without formal preoperative instruction or simulation.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Preoperative Simulation of Retropubic Midurethral Sling to Decrease Bladder Perforation Rate Among Obstetrics and Gynecology Residents

Shah¹,

Florian-Rodriguez

Meinhardt³

et al. 2022

UROGC

View full text Add to dashboard Cite

ImportanceBladder perforation is an often avoidable complication of retropubic midurethral sling procedures. Bladder injury rates decrease with surgeon experience, but literature on techniques to train novice surgeons is limited.ObjectiveOur objective was to decrease the bladder perforation rate among obstetrics and gynecology residents during retropubic midurethral sling procedures through implementation of an instructional video and low-fidelity simulation.Study DesignA baseline bladder perforation rate was determined by retrospective chart review. A prospective educational intervention, consisting of a 10-minute instructional video with preoperative simulation using a simple bony pelvis model, was then implemented among residents on the urogynecology service from December 2017 through March 2020. The primary outcome was the change in the bladder perforation rate. Compliance with the intervention protocol was a secondary outcome. Categorical data were evaluated using the χ2 or Fisher exact test. Continuous variables were assessed using the Student t test or Mann-Whitney U test as appropriate.ResultsTwo hundred fifteen retropubic midurethral sling cases were included in analysis. There were no significant demographic differences between the patients undergoing surgery preintervention and postintervention. Resident surgeons were in their second (47.4%) and third (52.6%) years of training. The postintervention bladder perforation rate was 6.5%, which is a 35% reduction from the preintervention perforation rate of 10% (P = 0.19). The instructional video and preoperative simulation were successfully implemented in 193 of 215 (89.8%) eligible cases.ConclusionDespite high compliance, the combination of the instructional video and preoperative low-fidelity bony pelvis simulation was not effective in reducing tension-free vaginal tape-associated bladder perforations among residents.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Why This Mattersmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Preoperative Simulation of Retropubic Midurethral Sling to Decrease Bladder Perforation Rate Among Obstetrics and Gynecology Residents

Shah¹,

Florian-Rodriguez

Meinhardt³

et al. 2022

UROGC

View full text Add to dashboard Cite

show abstract

“…Casiano et al (2012) reported that only 54 % of recent graduates rated uro-gynecology experience as acceptable, with increasing the surgical volume the single most important factor needed to enhance training. Sabourin et al (2012) studied to determine the effectiveness of a teaching module using simulation for the TVT procedure on procedural knowledge and skill on 25 obstetrics and gynecology (OBGYN) residents. They found a significant median improvement of 44 % on the written examination and at least one point on each of the self-rated competence and knowledge scales were observed after the teaching module.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a 3D Printed Female Anatomical Model for the Hands on Training of Trans-Obturator Tape (TOT) and Tension Free Vaginal Tape (TVT) Sling Procedures

2020

View full text Add to dashboard Cite

show abstract

“…Simulation training has been widely adopted for laparoscopic and robotic training in gynecology, but has been underutilized in the mastery of vaginal procedures [12-13]. Prior work has shown simulation to be effective for teaching MUS at the resident level [14]. This study is unique in that we utilized both quantitative and qualitative assessment to demonstrate improved MUS comfort and skill following training with a pelvic model and prosected cadaver pelvis.…”

Section: Discussionmentioning

confidence: 99%

Teaching the Retropubic Midurethral Sling Using a Novel Cadaver and Model-Based Approach

Oliphant

Littleton

Gosman

et al. 2017

Cureus

View full text Add to dashboard Cite

ObjectiveTo measure the impact of a model-based teaching program on resident comfort and skill with retropubic midurethral sling (MUS).Study designResidents were assessed before and after a retropubic MUS teaching session, which included a brief lecture and three interactive teaching stations (cadaver pelvis, retropubic MUS pelvic model, cystoscopy model). Self-assessment measures included MUS-related visual analog scale (VAS), Likert, and open-ended questions. Objective assessment measures were used to score blinded videos of trocar passage on a pelvic model, including a modified objective structured assessment of technical skills (mOSAT) and a retropubic MUS-specific checklist of surgical steps. Emerging themes from the open-ended questions were identified using grounded theory; analysis ceased once theme saturation was achieved.ResultsTwenty-five of 37 total residents participated in the training session and 24 participated in this study. Following training, VAS scores, Likert scores, and qualitative analysis indicated greater resident comfort with performing retropubic MUS, with relevant anatomy, and with trocar passage. Residents demonstrated improvement in model trocar passage post-training, with a rise in mOSAT score (47% to 65%; p = .01) and a rise in checklist score (61% to 75%; p = .11). Residents expressed discomfort due to inexperience with MUS, concern regarding trocar passage, and worry over potential complications. Residents reported feeling more prepared to perform MUS after the session. They stressed the importance of repetition and a comfortable learning environment for surgical training, and praised the “hands-on” training session.ConclusionWe demonstrate success using a short, single-session, hands-on group training session to improve comfort and skill with retropubic MUS.

show abstract

Improving Resident Competence and Knowledge Regarding Tension-Free Vaginal Tape Procedure

Abstract: A short teaching module and simulation session can effectively teach residents and improve their perceived competence with the TVT procedure.

Cited by 9 publications

References 2 publications

Preoperative Simulation of Retropubic Midurethral Sling to Decrease Bladder Perforation Rate Among Obstetrics and Gynecology Residents

Preoperative Simulation of Retropubic Midurethral Sling to Decrease Bladder Perforation Rate Among Obstetrics and Gynecology Residents

Evaluation of a 3D Printed Female Anatomical Model for the Hands on Training of Trans-Obturator Tape (TOT) and Tension Free Vaginal Tape (TVT) Sling Procedures

Teaching the Retropubic Midurethral Sling Using a Novel Cadaver and Model-Based Approach

Contact Info

Product

Resources

About