title: Implementation and evaluation of a dilation and evacuation simulation training curriculum.
abstract: To evaluate obstetrics and gynecology resident physicians' performance following a simulation curriculum on dilation and evacuation (D&E) procedures.
  
  
  
  This study included two phases: simulation curriculum development and resident physician performance evaluation following training on a D&E simulator. Trainees participated in two evaluations. Simulation training evaluated participants performing six cases on a D&E simulator, measuring procedural time and a 26-step checklist of D&E steps. The operative training portion evaluated residents' performance after training on the simulator using mastery learning techniques. Intra-operative evaluation was based on a 21-step checklist score, Objective Structured Assessment of Technical Skills (OSATS), and percentage of cases completed.
  
  
  
  Twenty-two residents participated in simulation training, demonstrating improved performance from cases one and two to cases five and six, as measured by checklist score and procedural time (p<.001 and p=.001, respectively). Of 10 participants in the operative training, all performed at least three D&Es, while seven performed at least six cases. While checklist scores did not change significantly from the first to sixth case (mean for first case: 18.3; for sixth case: 19.6; p=.593), OSATS ratings improved from case one (19.7) to case three (23.5; p=.001) and to case six (26.8; p=.005). Trainees completed approximately 71.6% of their first case (range: 21.4-100%). By case six, the six participants performed 81.2% of the case (range: 14.3-100%).
  
  
  
  D&E simulation using a newly-developed uterine model and simulation curriculum improves resident technical skills. Simulation training with mastery learning techniques transferred to high level of performance in OR using checklist. The OSATS measured skills and showed improvement in performance with subsequent cases.
  
  
  
  Implementation of a D&E simulation curriculum offers potential for improved surgical training and abortion provision.
authors: Department of Obstetrics and Gynecology, 1653 W. Congress Pkwy, 720 Pavilion, Rush University Medical Center, Chicago, IL, 60612. Electronic address: Sloane_L_York@Rush.edu.
authors: Sloane L
authors: SL
authors: York
authors: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors: William C
authors: WC
authors: McGaghie
authors: Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors: Jessica
authors: J
authors: Kiley
authors: Section of Family Planning and Contraception, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors: Cassing
authors: C
authors: Hammond
mesh_terms: D000028:Abortion, Induced / Q000193:education*; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D012044:Regression Analysis; D000066908:Simulation Training / Q000379:methods*; D014481:United States
keywords: Abortion; Dilation and evacuation; Mastery learning; Medical simulation; Resident education