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Simulation

Basic Hysteroscopy

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):

  1. Five-minute hysteroscope assembly OSATS 
  2. 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)