title: Training and Assessment of Hysteroscopic Skills: A Systematic Review.
abstract: OBJECTIVE
  The aim of this systematic review was to identify studies on hysteroscopic training and assessment.
  
  
  METHODS
  PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools.
  
  
  RESULTS
  A total of 25 studies on hysteroscopy training were identified, of which 23 were performed in simulated settings. Overall, 10 studies used virtual-reality simulators and reported effect sizes for technical skills ranging from 0.31 to 2.65; 12 used inanimate models and reported effect sizes for technical skills ranging from 0.35 to 3.19. One study involved live animal models; 2 studies were performed in clinical settings. The validity evidence supporting the assessment tools used was low. Consensus between the 2 raters on the reported validity evidence was high (94%).
  
  
  CONCLUSIONS
  This systematic review demonstrated large variations in the effect of different tools for hysteroscopy training. The validity evidence supporting the assessment of hysteroscopic skills was limited.
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark. Electronic address: mona_savran@hotmail.com.
authors.forename: Mona Meral
authors.initials: MM
authors.lastname: Savran
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
authors.forename: Stine Maya Dreier
authors.initials: SM
authors.lastname: Sørensen
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Konge
authors.affiliation: Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark; Department of Gynecology, University Hospital Nordsjaelland, Hillerod, Denmark.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Tolsgaard
authors.affiliation: Department of Gynecology, The Juliane Marie Centre for Children, Women and Reproduction, Copenhagen, Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Bjerrum
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical; D004521:Educational Measurement; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000193:education*
keywords: Medical Knowledge; Patient Care; Systems-Based Learning and Improvement; assessment; hysteroscopy; simulation; systematic review; training; validity