Lauren F Damle1, Eshetu Tefera2, Julie McAfee3, Mary K Loyd3, Allison M Jackson4, Tamika C Auguste5, Veronica Gomez-Lobo6. 1. MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC. Electronic address: Lauren.F.Damle@medstar.net. 2. MedStar Health Research Institute, Hyattsville, MD. 3. Simulation and Training Environment Lab, MedStar Health, Washington, DC. 4. Children's National Medical Center, Child and Adolescent Protection Center, Washington, DC. 5. MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC. 6. MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC; Children's National Medical Center, Department of Surgery, Washington, DC.
Abstract
STUDY OBJECTIVE: Develop a Pediatric and Adolescent Gynecology (PAG) curriculum, appropriate pelvic model for teaching examination skills, and an objective structured clinical examination (OSCE) for evaluation. Compare OSCE performance between residents with clinical training in PAG vs those that completed the curriculum vs those without either experience. DESIGN: Prospective cohort study. SETTING: Obstetrics and Gynecology (Ob/Gyn) residency program in an urban academic center. PARTICIPANTS: Senior Ob/Gyn residents. INTERVENTIONS: A simulation-based teaching curriculum was created to teach PAG skills. A pediatric mannequin with anatomic pre-pubertal genitalia was developed for teaching and assessment of skills. MAIN OUTCOME MEASURES: Performance on a PAG-based OSCE as assessed by 2 observers using a 40 point checklist. RESULTS: 17 residents participated in the OSCE; 5 completed the curriculum, 6 completed a clinical rotation, and 6 were controls. The teaching curriculum group had the highest median composite OSCE score (75.0%) compared to the clinical group (73.1%) and control group (55.3%). There was no statistical difference between the scores of the teaching and clinical groups, but the teaching group scored statistically higher than controls (P = .0331). Scores for each OSCE component were compared. The teaching and clinical groups outperformed controls on assessment and procedures. There was no difference in scores on history taking or physical examination. CONCLUSION: An interactive teaching curriculum incorporating simulation and a realistic pediatric pelvic model can be used to teach PAG clinical skills. Using an OSCE to evaluate skills shows that residents completing the curriculum perform as well as those with clinical experience and better than controls.
STUDY OBJECTIVE: Develop a Pediatric and Adolescent Gynecology (PAG) curriculum, appropriate pelvic model for teaching examination skills, and an objective structured clinical examination (OSCE) for evaluation. Compare OSCE performance between residents with clinical training in PAG vs those that completed the curriculum vs those without either experience. DESIGN: Prospective cohort study. SETTING: Obstetrics and Gynecology (Ob/Gyn) residency program in an urban academic center. PARTICIPANTS: Senior Ob/Gyn residents. INTERVENTIONS: A simulation-based teaching curriculum was created to teach PAG skills. A pediatric mannequin with anatomic pre-pubertal genitalia was developed for teaching and assessment of skills. MAIN OUTCOME MEASURES: Performance on a PAG-based OSCE as assessed by 2 observers using a 40 point checklist. RESULTS: 17 residents participated in the OSCE; 5 completed the curriculum, 6 completed a clinical rotation, and 6 were controls. The teaching curriculum group had the highest median composite OSCE score (75.0%) compared to the clinical group (73.1%) and control group (55.3%). There was no statistical difference between the scores of the teaching and clinical groups, but the teaching group scored statistically higher than controls (P = .0331). Scores for each OSCE component were compared. The teaching and clinical groups outperformed controls on assessment and procedures. There was no difference in scores on history taking or physical examination. CONCLUSION: An interactive teaching curriculum incorporating simulation and a realistic pediatric pelvic model can be used to teach PAG clinical skills. Using an OSCE to evaluate skills shows that residents completing the curriculum perform as well as those with clinical experience and better than controls.