Operators believe patient-specific rehearsal improve individual and team performance

What is the impact of simulation on the learning of hysteroscopic skills by residents and medical students? A systematic review

INTRODUCTION

Hysteroscopy is a critical procedure in gynecology for diagnosing and managing intrauterine pathology. Traditional hands-on training faces ethical and safety challenges, leading to an increased reliance on simulation training. This review systematically assesses the effectiveness of hysteroscopic simulation training in enhancing the technical skills of obstetrics and gynecology residents and medical students.

METHODS

A PRISMA-guided literature search was conducted, covering English-language articles from January 2000 to December 2023. Studies were selected based on pre-defined criteria, focusing on the impact of simulation training on the targeted educational group. Metrics for evaluating skill improvement included machine-recorded metrics, Objective Structured Assessment of Technical Skills (OSATS), and global rating scales.

RESULTS

The review included nine studies with varied designs, demonstrating significant improvements in hysteroscopic skills following simulation training. Virtual reality (VR) simulators showed substantial benefits in skill acquisition, while physical simulators provided valuable tactile feedback. However, long-term skill retention and the impact on non-technical skills were not adequately assessed.

CONCLUSIONS

Simulation-based training effectively enhances hysteroscopic skills in medical students and residents. Further research is needed to explore long-term skill retention and the development of non-technical competencies. Robust studies, including randomized trials, are required for definitive validation.

The Role of Simulators in Interdisciplinary Medical Work

This article reports from a project introducing a virtual reality simulator with patient-specific input for endovascular aneurysm repair (EVAR) into a surgical environment at a university hospital in Norway during 2016–2019. The project includes acquisition of the simulator, training of personnel, and a mapping of the effects. We followed the process, adopting ethnographic methods including participation in the operating room, simulated patient-specific rehearsals, preparations of the rehearsals, meetings with the simulator company, scientific meetings and scientific work related to the clinical trials (the second author led the clinical trial), in addition to open-ended interviews with vascular surgeons and interventional radiologists. We used the concepts of boundary work and sensework as conceptual lenses through which we studied the introduction of the simulator and how it influenced the nature of work and the professional relationship between the vascular surgeons and the interventional radiologists. We found that the simulator facilitated professional integration, at the same time as it served as a material resource for professional identity development. This study is the first to our knowledge that investigates the role of simulators for professional identity and relationship among surgeons and radiologists. Further studies of simulators in similar and different social contexts may contribute to deeper and more generic understanding of the way simulators influence our working life.