Introduction: Simulation is an essential and proven training tool in medical education. The simulation environment provides opportunities for trainees to gain technical competency in a safe environment. Simulation in medical education spans a broad spectrum—from low-fidelity, unmonitored skills training to high-fidelity, technically advanced multidisciplinary drills—adapting to the resources and objectives of each setting. In the field of Ob/Gyn, residency programs are built around the core objective of cultivating surgical competence through comprehensive training. Although the versatility of simulation is one of its greatest strengths, this variability underscores the critical need for objective evaluation of its effectiveness and a systematic approach to training core skills in Ob/Gyn residency. The CREOG Surgical Skills Task Force created a standardized surgical skills curriculum, Surgical Curriculum in Obstetrics and Gynecology (SCOG), with 27 units targeting key surgical techniques. Methods: Our Ob/Gyn residency—a mid-size, university-based training program—implemented a structured, two-year simulation curriculum under the direct supervision of a Simulation Director. We provided two hours of simulation training each month, comprising 20% of protected resident didactic learning time. The simulation curriculum incorporates both the SCOG units and modules originating within the program. We aimed to target both procedural and team-based communication skills. We collected data regarding resident knowledge with pre- and post-simulation testing from the SCOG units. Test scores were identified by residency training year to track differences in pre- and post-test scores according to level of training. We had access to space and resources of our university’s multidisciplinary simulation center to support our curriculum. Results: Over two years, our simulation curriculum trained residents using 15 out of 27 of the SCOG units and ten simulations created within our department or utilizing other educational materials. Our simulation curriculum contained 9 obstetric topics, 13 gynecology topics, and 3 non-technical skills topics. The Ob/Gyn residents consistently improved between pre-simulation and post-simulation tests. For each of the 15 SCOG units completed, 100% of residents participating had a post-simulation passing score of 80% or greater. For the SCOG units completed, pre-simulation test scores ranged from 56% to 97%, with a mean score of 72.6% ± 12.2%. Post-simulation test scores ranged from 88% to 100%, with a mean post-simulation test score of 94.2% ± 4.3%. Scores were divided by class to show differences in degree of improvement at different training levels. Discussion: The differences in pre- and post-simulation test scores show improvement in clinical knowledge after implementation of the SCOG units. Our simulation program serves as a model for integrating a standardized simulation curriculum into resident training with objective measures of efficacy. In addition, topics not covered by the SCOG units can be incorporated into the simulation curriculum, using the same principles of effective simulation and assessment. Strengths of our program include a dedicated Simulation Director, a systematic approach to curriculum design, and use of low cost, low fidelity models. Moving forward, our program aims to incorporate objective evaluation of learner skills in addition to the measures of clinical knowledge. Future goals also include measuring resident feedback of the simulations to demonstrate learner satisfaction and identify areas for improvement.
Allred et al. (Sun,) studied this question.
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