title: Does an Advanced Pelvic Simulation Curriculum Improve Resident Performance on a Pediatric and Adolescent Gynecology Focused Objective Structured Clinical Examination? A Cohort Study.
abstract: OBJECTIVE
  To determine the effect of an advanced pelvic simulation curriculum on resident performance on a pediatric and adolescent gynecology (PAG) focused objective structured clinical examination (OSCE).
  
  
  METHODS
  Obstetrics and gynecology residents in a single academic Canadian center participated in a PAG simulation curriculum. An OSCE on prepubertal vaginal bleeding was administered at the biannual OSCE examination 2 months before the simulation curriculum and again 3 months after the simulation curriculum.
  
  
  METHODS
  Academic half-day at the University of Ottawa Skills and Simulation Centre.
  
  
  METHODS
  Obstetrics and gynecology residents from the University of Ottawa.
  
  
  METHODS
  Participants completed 4 stations teaching PAG-appropriate history-taking, genital examination, Tanner staging, vaginal sampling and flushing, hymenectomy, vaginoscopy, laparoscopic adnexal detorsion, and approach to the child and/or adolescent. Advanced pelvic models were used for procedure-specific stations.
  
  
  METHODS
  The primary outcome measure was change in mean score on a prepubertal vaginal bleeding OSCE station. Secondary outcome measures were changes in individual component scores.
  
  
  RESULTS
  Fourteen residents completed the simulation curriculum and the PAG OSCE at the 2 separate time points (before and after simulation curriculum). The mean OSCE score before the simulation curriculum was 54.6% (20.5 of 37) and mean score after the curriculum was 78.1% (28.9 of 37; P < .001). Significant score increases were found in history-taking, examination, differential diagnosis, identification of organism, surgical procedures, and identification of foreign body (P < .01 for all).
  
  
  CONCLUSIONS
  This innovative PAG simulation curriculum significantly increased residents' knowledge in PAG history-taking, examination skills, operative procedures, and approach to the child and/or adolescent. Obstetrics and Gynecology Program Directors should consider incorporating PAG simulation training into their curriculum to ensure that residents meet their learning objectives and increase their knowledge and confidence, which will ultimately benefit patient care.
authors.affiliation: Division of Gynecology, Children's Hospital of Eastern Ontario, and Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: tdumont@cheo.on.ca.
authors.forename: Tania
authors.initials: T
authors.lastname: Dumont
authors.affiliation: Division of Gynecology, Children's Hospital of Eastern Ontario, and Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Hakim
authors.affiliation: Division of Gynecology, Children's Hospital of Eastern Ontario, and Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: Black
authors.affiliation: Division of Gynecology, Children's Hospital of Eastern Ontario, and Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fleming
mesh_terms: D000293:Adolescent; D002170:Canada; D002983:Clinical Competence; D015331:Cohort Studies; D003479:Curriculum; D005260:Female; D058869:Gynecological Examination / Q000379:methods*; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education; D009774:Obstetrics / Q000193:education*; D010372:Pediatrics / Q000193:education*
keywords: Adolescent; Curriculum; Gynecology; OSCE; Objective structured clinical examination; Pediatric; Postgraduate medical education; Simulation; Teaching