Improving Resident Comfort With Peripartum Cesarean Hysterectomy Through the Use of Low-Fidelity Simulation Models.

Autor:	Frenn R; Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Chicago, USA., Heisler E; Obstetrics and Gynecology, New York University, New York, USA., Chen G; Obstetrics and Gynecology, Adventist Health White Memorial, Los Angeles, USA., Zoorob D; Obstetrics and Gynecology, LSU Health Sciences Center in Shreveport, Shreveport, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 10; Vol. 16 (9), pp. e69056. Date of Electronic Publication: 2024 Sep 10 (Print Publication: 2024).
DOI:	10.7759/cureus.69056
Abstrakt:	Introduction Cesarean hysterectomy is a relatively rarely performed, complex, life-saving procedure considered during post-partum hemorrhage and other obstetric complications. This multi-site study aimed at validating a low-cost, low-fidelity cesarean hysterectomy model to support resident proficiency and increase their confidence in performing this critical procedure. Materials and methods We developed a low-fidelity, anatomically representative model for cesarean hysterectomy simulation purposes. Obstetrics and Gynecology residents at two residency programs were offered a simulation experience using the model, with a performance assessment via two validated assessment tools. The clinical case involved a 38 y/o woman with a delivery complicated by postpartum hemorrhage who failed conservative therapy and required a peripartum hysterectomy. Participants included 26 residents, postgraduate year (PGY)1 through PGY4, at two midwestern university-based obstetrics and gynecology residency programs. Results The median resident scores on the Task Specific Checklist (TSC) and Global Rating Scale (GRS) correlated with increasing PGY levels. The combined TSC+GRS score was a median of 40 out of 49 total for the PGY4 class, while the PGY1 class had a median combined TSC+GRS score of 12 of 49. The PGY2 and -3 classes had TSC+GRS scores of 14 and 28, respectively. The simulation model was well-received with a median 4/5 rating for improving comfort level with cesarean hysterectomy and a median 4/5 rating for model realism. Conclusion This study validated a cost-effective, easily reproducible model that highlights the vital anatomy relevant to a cesarean hysterectomy. The model and simulation offer a way to introduce cesarean hysterectomies to residents while in training, particularly at sites that may not perform a substantial number of these procedures. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Boards of Loyola University and University of Toledo issued approval 19-001-PHS. IRB approval was obtained from both institutions. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: Not an external source but the study was grant-funded. York Educational Research Grant from the Stritch School of Medicine (5000 USD). Financial relationships: Dani Zoorob declare(s) Surgical Educator and Travel Support from Applied Medical. Surgical Educator and Travel Support. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Frenn et al.)
Databáze:	MEDLINE
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