title: Pediatric and Adolescent Gynecology Education through Simulation (PAGES): Development and Evaluation of a Simulation Curriculum.
abstract: OBJECTIVE
  Develop a Pediatric and Adolescent Gynecology (PAG) curriculum, appropriate pelvic model for teaching examination skills, and an objective structured clinical examination (OSCE) for evaluation. Compare OSCE performance between residents with clinical training in PAG vs those that completed the curriculum vs those without either experience.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Obstetrics and Gynecology (Ob/Gyn) residency program in an urban academic center.
  
  
  METHODS
  Senior Ob/Gyn residents.
  
  
  METHODS
  A simulation-based teaching curriculum was created to teach PAG skills. A pediatric mannequin with anatomic pre-pubertal genitalia was developed for teaching and assessment of skills.
  
  
  METHODS
  Performance on a PAG-based OSCE as assessed by 2 observers using a 40 point checklist.
  
  
  RESULTS
  17 residents participated in the OSCE; 5 completed the curriculum, 6 completed a clinical rotation, and 6 were controls. The teaching curriculum group had the highest median composite OSCE score (75.0%) compared to the clinical group (73.1%) and control group (55.3%). There was no statistical difference between the scores of the teaching and clinical groups, but the teaching group scored statistically higher than controls (P = .0331). Scores for each OSCE component were compared. The teaching and clinical groups outperformed controls on assessment and procedures. There was no difference in scores on history taking or physical examination.
  
  
  CONCLUSIONS
  An interactive teaching curriculum incorporating simulation and a realistic pediatric pelvic model can be used to teach PAG clinical skills. Using an OSCE to evaluate skills shows that residents completing the curriculum perform as well as those with clinical experience and better than controls.
authors.affiliation: MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC. Electronic address: Lauren.F.Damle@medstar.net.
authors.forename: Lauren F
authors.initials: LF
authors.lastname: Damle
authors.affiliation: MedStar Health Research Institute, Hyattsville, MD.
authors.forename: Eshetu
authors.initials: E
authors.lastname: Tefera
authors.affiliation: Simulation and Training Environment Lab, MedStar Health, Washington, DC.
authors.forename: Julie
authors.initials: J
authors.lastname: McAfee
authors.affiliation: Simulation and Training Environment Lab, MedStar Health, Washington, DC.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Loyd
authors.affiliation: Children's National Medical Center, Child and Adolescent Protection Center, Washington, DC.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Jackson
authors.affiliation: MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC.
authors.forename: Tamika C
authors.initials: TC
authors.lastname: Auguste
authors.affiliation: MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC; Children's National Medical Center, Department of Surgery, Washington, DC.
authors.forename: Veronica
authors.initials: V
authors.lastname: Gomez-Lobo
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine / Q000193:education*; D002648:Child; D002983:Clinical Competence; D003479:Curriculum; D004521:Educational Measurement; D005260:Female; D058869:Gynecological Examination; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008348:Manikins; D010372:Pediatrics / Q000193:education*; D011247:Pregnancy; D011446:Prospective Studies
keywords: Objective structured clinical examination; Pediatric and adolescent gynecology; Resident education; Simulation