title: Objective Structured Assessment of Technical Skills (OSATS) evaluation of hysteroscopy training: a prospective study.
abstract: OBJECTIVE
  To describe the performance curve of hysteroscopy-naïve probands repeatedly working through a surgery algorithm on a hysteroscopy trainer.
  
  
  METHODS
  We prospectively recruited medical students to a 30min demonstration session teaching a standardized surgery algorithm. Subjects subsequently performed three training courses immediately after training (T1) and after 24h (T2) and 48h (T3). Skills were recorded with a 20-item Objective Structured Assessment of Technical Skills (OSATS) at T1, T2, and T3. The presence of a sustained OSATS score improvement from T1 to T3 was the primary outcome. Performance time (PT) and self assessment (SA) were secondary outcomes. Statistics were performed using paired T-test and multiple linear regression analysis.
  
  
  RESULTS
  92 subjects were included. OSATS scores significantly improved over time from T1 to T2 (15.21±1.95 vs. 16.02±2.06, respectively; p<0.0001) and from T2 to T3 (16.02±2.06 vs. 16.95±1.61, respectively; p<0.0001). The secondary outcomes PT (414±119s vs. 357±88s vs. 304±91s; p<0.0001) and SA (3.02±0.85 vs. 3.80±0.76 vs. 4.41±0.67; p<0.0001) also showed an improvement over time with quicker performance and higher confidence. SA, but not PT demonstrated construct validity. In a multiple linear regression analysis, gender (odds ratio (OR) 0.96; 95% confidence interval (CI) 0.35-2.71; p=0.9) did not independently influence the likelihood of OSATS score improvement.
  
  
  CONCLUSIONS
  In a hysteroscopy-naïve population, there is a continuous and sustained improvement of surgical proficiency and confidence after multiple training courses on a hysteroscopy trainer. Serial hysteroscopy trainings may be helpful for teaching hysteroscopy skills.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Ferizan
authors.initials: F
authors.lastname: Alici
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Buerkle
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany. Electronic address: clemens.tempfer@marienhospital-herne.de.
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D002983:Clinical Competence; D004521:Educational Measurement; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008953:Models, Anatomic; D010388:Pelvis; D013337:Students, Medical
keywords: Hysteroscopic surgery; Hysteroscopy; OSATS; Technical skills; Training