May 28, 2015By Lance Baily Article Shares How Simulation Builds Skills in OB/GYN & Surgery

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Today a recent article from two Doctors on covering the fact that Simulation Builds Skills in Contemporary OB/Gyn & Surgery departments from Dr. Levine, clinical fellow, and Dr. Goldschlag, Assistant Professor of Clinical Reproductive Medicine, both from the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at the Weill Cornell Medical College at New York Presbyterian Hospital.

Excerpt from the Article:

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In 1999, the Institute of Medicine (IOM) issued the report To Err Is Human. In it, the IOM’s Committee on Quality of Health Care in America stated that not only did preventable medical errors cause more deaths than such feared threats as motor-vehicle accidents, breast cancer, and AIDS, but also that errors with serious consequences were most likely to occur in intensive care units, emergency departments, and operating rooms. Although some operating room-associated complications can be attributed to wrong-site surgeries and equipment malfunctions, countless patients are harmed because of physician skill deficiencies.

It is sad but true that many ob/gyn residents are still trained using a Halstedian approach that can be boiled down to the infamous “See one, do one, teach one.” Contrary to this philosophy of surgical education, surgery is not something that is  best taught by seeing, or best mastered by attempting on live subjects. There is an unavoidable practical element to effective surgical education, but no patient wants to be the “one” for a resident attempting to master a surgical procedure, especially in a fast-paced, high-stress clinical learning environment.

Even though surgery is a key part of ob/gyn training, a survey of residency programs found that only 74% formally evaluate surgical skills, with the majority reporting subjective faculty evaluations as the primary method of assessing skill proficiency. This occurs despite the availability of thoroughly vetted measures such as the objective structured assessment of technical skills (OSATS), the observational clinical human reliability assessment (OCHRA), and the operative performance rating system (OPRS).

One question that remains is how to procure simulator training experience in the current environment. As the AAMC survey revealed, many hospitals and medical schools have simulation core facilities. Scheduling training time may be as simple as calling the administrator of education in your ob/gyn department. For clinicians in community or private practices who do not have access to academic centers, national and district meetings such as those of ACOG and AAGL offer wonderful training sessions that are taught by our nation’s leading teachers using realistic simulators. Many surgical instrument sales representatives have access to simulation facilities. Simulation is an important part of surgical training and maintenance of skills and for those who want the training, the resources are available.

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