title: Teaching Vaginal Surgery to Junior Residents: Initial Validation of 3 Novel Procedure-Specific Low-Fidelity Models.
abstract: OBJECTIVE
  Competency-based surgical education relies on operative models to teach surgical skills within a curriculum. Low fidelity simulation has been shown to improve surgical performance. Our objectives were: to develop procedure-specific models to teach anterior repair (AR), posterior repair (PR), and vaginal hysterectomy (VH) to junior residents; to establish model reliability and validity.
  
  
  METHODS
  Residents were randomized to control (no training) and intervention (model training) groups. They were filmed while performing a series of tasks. Experts were also filmed. Each video was scored by 2 blinded raters.
  
  
  METHODS
  Multicenter collaboration within the Western Society of Pelvic Medicine (Vancouver, Calgary, and Edmonton). Face and content validity were evaluated. A standard scoring tool was developed for performance evaluation. Interrater reliability was assessed using intraclass correlation coefficient. Cronbach α was calculated for internal consistency. Jonckheere-Terpstra test verified whether the scores increased with operator skill level.
  
  
  METHODS
  A total of 14 junior gynecology residents, 2 urogynecology fellows, and 3 staff urogynecologists were rated by a total of 6 gynecologic surgeons who scored 42 videos each.
  
  
  RESULTS
  Experienced pelvic surgeons from 3 participating sites agreed the models captured essential elements of real surgical skills (face validity) and of the true procedures (content validity). Intraclass correlation coefficient was adequate (AR = 0.86, PR = 0.90, and VH = 0.87). Cronbach α for the total scores was adequate (AR = 0.85, PR = 0.8, and VH = 0.71). Performance score increased with operator skill level for all 3 procedures (AR, p = <0.001; PR, p = 0.008; and VH, p = 0.007).
  
  
  CONCLUSIONS
  Our low fidelity procedure-specific vaginal surgery models had adequate initial validity. Future research will investigate transferability of acquired skills to the operating room.
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: roxygeo@hotmail.com.
authors.forename: Roxana
authors.initials: R
authors.lastname: Geoffrion
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Suen
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Koenig
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Yong
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Brennand
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Mehra
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Maryse
authors.initials: M
authors.lastname: Larouche
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Terry
authors.initials: T
authors.lastname: Lee
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Todd
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D000066908:Simulation Training; D014621:Vagina / Q000601:surgery
keywords: Interpersonal and Communication Skills; Medical Knowledge; Practice-Based Learning and Improvement; junior residents; low fidelity simulation; vaginal surgery