Simulation
Materials
- Station ideally has two residents and one faculty preceptor
- Medical equipment per station:
- Endoscopic tower
- Diagnostic hysteroscope
- 1000 cc bags 0.9% NaCl (not necessary if running a dry lab)
- Tubing for inflow and out flow (not necessary if running a dry lab)
- Uterine model: can often be obtained from local Ethicon rep uterine model trays
- Bell pepper (one per resident)*
- Grasping forceps and scissors (only for bell pepper lab)
Lab Sequence
The intended sequence of events for this lab involves two initial OSATS (observed structured assessment of technical skills):
- Five-minute hysteroscope assembly OSATS
- Five-minute diagnostic hysteroscope OSATS or 10-minute bell pepper lab
The faculty should make certain that none of the equipment is damaged and only intervene if damage to the equipment appears imminent.
Competency Assessment
Hysteroscope Assembly
- Residents should be able to assemble the hysteroscope correctly and obtain an image in less than five minutes to be considered competent in this task
- Correctly naming and proper order of assembly will be noted as mastery of this task
Diagnostic Hysteroscopy
Residents should be able to:
- Identify cervical canal, junction of canal and lower uterine segment and both tubal ostia
- Identify each of the intrauterine pathologic features in less than five minutes in order to be considered competent
- Properly rotate the scope to maximize the use of the angled lens and minimize uterine manipulation and torque
Bell Pepper Lab
Residents should be able to:
- Identify the seeds and septa
- Remove three seeds with a grasper and excise a 1cm segment of the septa to be considered competent
- Properly rotate the scope to maximize the use of the angled lens not dropping any seeds and excising the septa segment all without any redundant moves (will be considered mastery)
The CREOG Surgical Skills Task Force created this simulation as part of a standardized surgical skills curriculum for use in training residents in obstetrics and gynecology.