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Effectiveness of Simulation Training in Improving the Operative Performance of the Essure Procedure

 

Chavan NR, Santandreu O, Jacobs AJ. Dept. of Obstetrics & Gynecology,Flushing Hospital Medical Center, Flushing, New York

Journal of Minimally Invasive Gynecology 19 (2012) S1–S35

Study Objective

To evaluate the impact of a hysteroscopic simulation training program for improving the operative performance of residents and attending physicians for the Essure procedure.

Design

Prospective cohort study of 136 cases of the Essure procedure performed over a one year period, before / after the implementation of a simulation training program, and a pre/post intervention survey of 58 providers.

Intervention

Simulation training using the EssureSim program. Measurements and Main Results: We prospectively followed two consecutive cohorts of patients undergoing the Essure procedure over a 1 year period from Feb’11 through Jan’12 - 58 cases before and 78 cases after implementation of the EssureSim (VirtaMed AG, Switzerland) simulation program, among residents (n = 14) and attending physicians (n = 44). The time to deployment (time from entering endocervical canal to microinsert placement) was significantly shorter after simulation training, as was the total operating room (OR) time. These cases had a significantly lower frequency of requiring > 2 essure coils for successful insertion. There was no significant difference in the pre/post simulation operative performance of residents versus attending physicians, in the subgroup analyses across provider groups. We also conducted a pre/post test survey of providers and examined their pre/post training simulated performance. The post intervention group had a significantly shorter simulated time to deployment, a lower frequency of requiring > 2 essure coils for successful insertion and reported a higher level of operative comfort in independently performing the Essure procedure.

Conclusion

Simulation training using the EssureSim program is an effective means of improving the operative performance of both residents and attending physicians for the Essure procedure. Incorporation of a hysteroscopic simulation lab in residency training can potentially augment the operative comfort of residents and enhance their surgical skill.

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