title: Training of hysteroscopic skills in residency program: the Dutch experience.
abstract: OBJECTIVE
  To evaluate whether hysteroscopy training in the Dutch gynecological residency program is judged as sufficient in daily practice, by assessment of the opinion on hysteroscopy training and current performance of hysteroscopic procedures. In addition, the extent of progress in comparison with that of the residency program of a decade ago is reviewed.
  
  
  METHODS
  Survey (Canadian Task Force Classification III).
  
  
  METHODS
  Postgraduate years 5 and 6 residents in obstetrics and gynecology and gynecologists who finished residency within 2008 to 2013 in the Netherlands.
  
  
  METHODS
  Subjects received an online survey regarding performance and training of hysteroscopy, self-perceived competence, and hysteroscopic skills acquirement.
  
  
  RESULTS
  Response rate was 65% of the residents and 73% of the gynecologists. Most residents felt adequately prepared for basic hysteroscopic procedures (86.7%), but significantly less share this opinion for advanced procedures (64.5%) (p < 0.01). In comparison with their peers in 2003, the current residents demonstrated a 10% higher appreciation of the training curriculum. However, their self-perceived competence did not increase, except for diagnostic hysteroscopy. Regarding daily practice, not only do more gynecologists perform advanced procedures nowadays but also their competence level received higher scores in comparison with gynecologists in 2003. Lack of simulation training was indicated to be the most important factor during residency that could be enhanced for optimal acquirement of hysteroscopic skills.
  
  
  CONCLUSIONS
  Implementation of hysteroscopic procedures taught during residency training in the Netherlands has improved since 2003 and is judged as sufficient for basic procedures. The skills of surgical educators have progressed toward a level in which gynecologists feel competent to teach and supervise advanced hysteroscopic procedures. Even though the residency preparation for hysteroscopy is more highly appreciated than a decade ago, this study indicated that simulation training might serve as an additional method to improve hysteroscopic skills acquisition. Future research is needed to determine the value of simulation training in hysteroscopy.
authors.affiliation: Department of Gynecology & Obstetrics, St. Antonius Hospital, Nieuwegein, The Netherlands. Electronic address: Julienne.Janse@gmail.com.
authors.forename: Juliënne A
authors.initials: JA
authors.lastname: Janse
authors.affiliation: Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Sara R C
authors.initials: SR
authors.lastname: Driessen
authors.affiliation: Department of Gynecology & Obstetrics, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Veersema
authors.affiliation: Division of Woman & Baby, Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frank J M
authors.initials: FJ
authors.lastname: Broekmans
authors.affiliation: Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Frank W
authors.initials: FW
authors.lastname: Jansen
authors.affiliation: Division of Woman & Baby, Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Henk W R
authors.initials: HW
authors.lastname: Schreuder
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D015907:Hysteroscopy / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D009426:Netherlands
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; gynecology; hysteroscopy; medical education; residency; training