title: A low-fidelity total abdominal hysterectomy teaching model for obstetrics and gynecology residents.
abstract: BACKGROUND
  The objective is to develop a low-fidelity total abdominal hysterectomy (TAH) model for resident training with the purpose to improve residents' knowledge of anatomy, instruments, instrument handling, suture selection, and steps of a TAH.
  
  
  METHODS
  A TAH model was created using products purchased from a crafts store. Obstetrics and gynecology residents (second-year residents and fourth-year residents) were subjected to a lecture followed by a simulated TAH. Before and after the course, subjects were given a survey to assess their confidence regarding the different surgical aspects of the TAH. Confidence was assessed regarding knowledge of anatomy, instruments, instrument handling, suture selection, incision site, steps of the TAH, and global confidence. Statistical analysis was performed using nonparametric tests. A P < 0.05 was considered significant.
  
  
  RESULTS
  A low-fidelity TAH model was created. Eight second-year residents and seven fourth-year residents were studied. As expected, second-year residents had a lower median number of hysterectomies performed as primary surgeon when compared with fourth-year residents [0.5 (0.0-1.75) vs. 51.0 (50.0-53.0); P < 0.05]. Despite this difference, after having undergone the course, both resident classes demonstrated either statistical trends or significantly increased surgical confidence in all areas studied.
  
  
  CONCLUSIONS
  Our novel, low-fidelity TAH simulation model and course improves obstetrics and gynecology residents' confidence in surgical skills and knowledge, particularly for those with less surgical experience. The total cost to make approximately 18 models was US $60.00.
authors.affiliation: Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: Alfred
authors.initials: A
authors.lastname: Hong
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Mullin
authors.forename: Laila
authors.initials: L
authors.lastname: Al-Marayati
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Peyre
authors.forename: Laila
authors.initials: L
authors.lastname: Muderspach
authors.forename: Heather
authors.initials: H
authors.lastname: Macdonald
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Ouzounian
authors.forename: David A
authors.initials: DA
authors.lastname: Miller
authors.forename: Neisha
authors.initials: N
authors.lastname: Opper
authors.forename: Richard H
authors.initials: RH
authors.lastname: Lee
mesh_terms: D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D004522:Educational Status; D005260:Female; D013502:General Surgery / Q000193:education; D006176:Gynecology / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods*; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008953:Models, Anatomic; D017145:Models, Educational; D009774:Obstetrics / Q000193:education*; D018709:Statistics, Nonparametric; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D014481:United States