(868) Prospective comparison of two cost-effective cervical cerclage simulation models for OBGYN resident training

Vaginal suturing techniques needed for proper cerclage placement in management of cervical insufficiency are challenging to teach and learn due to limited operative field visualization. The objective of this study was to compare the use and efficacy of two novel, low-cost models for cervical cerclage placement in resident training

Study Design:
A low fidelity plastic and woodmodel and a higher complexity 3-D printed silicone model of the vaginal canal and cervix were developed by the research team. The plastic model was made out of a 1 liter bottle and OBGYN residents were recruited for a 2-hour simulation where they practiced cerclage placement on both models. They were assigned randomly to order of model use to reduce performance bias. Residents completed pre- and post-simulation surveys assessing comfort and need for further training using a Likert scale (1=strongly disagree, 5=strongly agree). Responses were analyzed using descriptive statistics and paired t-tests.

Results:
Twenty-one OBGYN residents with an average of 2.6 (SD 1.2) years of training participated in the simulation session. Pre- and post-simulation surveys revealed a significant increase in confidence in suturing ability (3.0 vs. 4.3, p< 0.001) and decrease in perceived need for further training in cerclage placement (4.3 vs 3.7, p=0.04) (Figure 1). In comparing silicone and plastic
models, residents had a strong preference for the silicone model for future training (4.7 vs 2.5, p< 0.001), noting that it had better texture (4.3 vs 1.8, p< 0.001) and anatomic realism (4.5 vs 2.3, p< 0.001) (Figure 2)

Conclusion:

Usage of simulation models, particularly the silicone model with improved anatomic realism, for cerclage training increased resident comfort levels with the procedure and enhanced overall resident satisfaction and educational experience.