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Use of pelvic model-based simulation for sacrospinous ligament fixation education in novice learners: a single-blinded randomized controlled trial

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Abstract

Introduction and hypothesis

We hypothesize that there will be improvement in a novice learners’ confidence and skill level with sacrospinous ligament fixation (SSLF) following a pelvic model-based simulation.

Methods

We performed a single-blinded randomized controlled trial with obstetrics and gynecology residents who were novices at SSLF. The residents were randomly assigned to two groups. The control group received a lecture on the SSLF procedure and anatomy, whereas the intervention group received the same lecture in addition to a pelvic model-based simulation session taught by urogynecologists. The residents’ knowledge of SSLF anatomy and confidence level with the procedure were measured via assessments administered before and after the educational interventions. Their technical skills were objectively assessed by one of two fellowship-trained urogynecologists who were blinded to their group allocation.

Results

A total of 28 residents were recruited with 14 residents in each group and equal distribution of junior and senior trainees. None of the residents had previously performed the SSLF procedure. There was no difference in anatomical knowledge between the two groups. The intervention group showed a greater increase in their average confidence score compared with the control group: 4.0 ± 1.4 (95% CI 3.1–4.8) versus 2.6 ± 1.6 (95% CI 1.7–3.4) respectively, with p = 0.02. The intervention group also showed better objective scores in specific technical skills, such as instrument handling (p < 0.001), instrument movement/motion (p < 0.001), and speed (p = 0.01).

Conclusion

Our results demonstrate that inclusion of a pelvic model simulation significantly improves confidence and certain technical skills of novice trainees in performing SSLF.

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Acknowledgements

Charles Khamis, MS, MBA, from Boston Scientific™, for assistance with cadaveric dissections; Youngju Pak for statistical analysis.

Funding

Grants received from the Committee of Interns and Residents in Los Angeles, CA (grant number: 031601–01-00), and Boston Scientific™ (grant number: ISRURO00070).

Author information

Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA, 90509, USA

    Yoko Takashima, Stephanie J. Handler & Tajnoos Yazdany

  2. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Keck Hospital of USC, Los Angeles, CA, USA

    Aldene Zeno

  3. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA

    Brian Miyazaki & Tam Hoang Le

  4. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Isabel del Canto

Authors
  1. Yoko Takashima
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  2. Stephanie J. Handler
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  3. Aldene Zeno
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  4. Brian Miyazaki
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  5. Isabel del Canto
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  6. Tajnoos Yazdany
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  7. Tam Hoang Le
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Contributions

Y. Takashima: project development, cadaveric dissection, involvement in the simulation session, data collection, data analysis, manuscript writing; S. Handler: project development, cadaveric dissection, involvement in the simulation session, manuscript writing; A. Zeno: project development, cadaveric dissection, involvement in the simulation session; B. Miyazaki: project development, cadaveric dissection, involvement in simulation session, manuscript writing; I. Del Canto: cadaveric dissection, involvement in the simulation session, data collection; T. Yazdany: project development, involvement in simulation session, manuscript writing; T. Le: project development, cadaveric dissection, involvement in the simulation session, manuscript writing.

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Correspondence to Yoko Takashima.

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Takashima, Y., Handler, S.J., Zeno, A. et al. Use of pelvic model-based simulation for sacrospinous ligament fixation education in novice learners: a single-blinded randomized controlled trial. Int Urogynecol J 32, 897–903 (2021). https://doi.org/10.1007/s00192-020-04445-8

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  • DOI: https://doi.org/10.1007/s00192-020-04445-8

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