Original Articles

The Effect of a Short Training Course of Hysteroscopic Myoma Resection on the Non-Technical Skills of Gynecologic Surgeons

Abstract

Objective: To assess the impact of a hysteroscopic myoma resection (HMR) two-day training course on non-technical (cognitive) surgical skills among gynecologists.
Materials and methods: A 2-day educational course was held in which 95 consultant gynecologic surgeons and beginner infertility fellowship residents took part. Among all 80 participants (84.2%) had ever performed diagnostic hysteroscopy and 30 (31.3%) had performed non-resectoscopic operative hysteroscopy. The training program included instructive speeches, simulated surgical presentations, and a live hands-on myomectomy workshop. Non-technical skills were assessed two times, once before and the other after the course through two written tests with 10 multiple-choice questions for each.
Results: Concerning the 95 participants, 43 (47.3%) took the pre-course test and all of them (100%) took the post-course one. The mean score improved significantly from 3 (interquartile range [IQR],
0–4.0) to 7 (IQR, 5.0– 8.0) [bootstrap p<0.0001] for each of the randomly chosen pairings. The majority of candidates showed significantly improved cognitive skills after the HMR course despite their poor cognitive skills before the course. According to further analysis, there were significant enhancements in grades for all topics, especially regarding the basic principles of the procedure and management of complications (bootstrap p<0.0001). The odds ratio for the pre- versus post-course mean test results was 5.23. Due to the confidentiality stipulation, the pre- and post-course scores were not matched.
Conclusion: A two-day continuing medical educational course could be efficient in improving the non-technical (cognitive) skills for HMR.

1. Rogers RM Jr, Julian TM. Training the gynecologic surgeon. Obstet Gynecol. 2005;105(1):197-200.
2. Cosman P, Hemli JM, Ellis AM, Hugh TJ. Learning the surgical craft: a review of skills training options. ANZ
J Surg. 2007;77(10):838-45.
3. VanBlaricom AL, Goff BA, Chinn M, Icasiano MM, Nielsen P, Mandel L. A new curriculum for hysteroscopy training is demonstrated by an objective structured assessment of technical skills (OSATS). Am J Obstet Gynecol. 2005;193(5):1856-65.
4. Burchard ER, Lockrow EG, Zahn CM, Dunlow SG, Satin AJ. Simulation training improves resident performance in operative hysteroscopic resection techniques. Am J Obstet Gynecol. 2007;197(5):542.e1-4.
5. Coleman RL, Muller CY. Effects of a laboratory-based skills curriculum on laparoscopic proficiency: A randomized trial. Am J Obstet Gynecol. 2002;186(4):836-42.
6. Wong JA, Matsumoto ED. Primer: cognitive motor learning for teaching surgical skills--how are surgical skills taught and assessed? Nat Clin Pract Urol. 2008;5(1):47-54.
7. Reznick RK, MacRae H. Teaching surgical skills-changes in the wind. N Engl J Med. 2006;355(25):2664-9.
8. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6):614-21.
9. Whittaker G, Abboudi H, Khan MS, Dasgupta P, Ahmed K. Teamwork Assessment Tools in Modern Surgical Practice: A Systematic Review. Surg Res Pract. 2015;2015:494827.
10. Brunckhorst O, Shahid S, Aydin A, Khan S, McIlhenny C, Brewin J, Sahai A, Bello F, Kneebone R, Shamim Khan M, Dasgupta P, Ahmed K. The Relationship Between Technical And Nontechnical Skills Within A Simulation-Based Ureteroscopy Training Environment. J Surg Educ. 2015;72(5):1039-44.
11. Yule S, Flin R, Paterson-Brown S, Maran N. Non-technical skills for surgeons in the operating room: a review of the literature. Surgery. 2006 Feb;139(2):140-9.
12. Nguyen N, Elliott JO, Watson WD, Dominguez E. Simulation Improves Nontechnical Skills Performance of Residents During the Perioperative and Intraoperative Phases of Surgery. J Surg Educ. 2015;72(5):957-63.
13. Majumder AA, D'Souza U, Rahman S. Trends in
medical education: challenges and directions for
need-based reforms of medical training in South-East Asia. Indian J Med Sci. 2004;58(9):369-80.
14. Alvand A, Gill HS, Price AJ, Dodd CA, Murray DW, Rees JL. Does a mixed training course on the Oxford unicompartmental knee arthroplasty improve the
non-technical skills of orthopaedic surgeons? J Orthop Surg (Hong Kong). 2012;20(3):356-60.
15. Bjerre LM, Paterson NR, McGowan J, Hogg W, Campbell C, Viner G, Archibald D. Do Continuing Medical Education (CME) events cover the content physicians want to know? A content analysis of CME offerings. J Contin Educ Health Prof. 2015;35(1):27-37.
16. He C, Söffker D. Quantification of human behavior levels by extending Rasmussen's SRK model and the effects of time pressure and training on the levels switching. Heliyon. 2023 Mar 29;9(4):e15019.
17. Di Spiezio Sardo A, Taylor A, Tsirkas P, Mastrogamvrakis G, Sharma M, Magos A. Hysteroscopy: a technique for all? Analysis of 5,000 outpatient hysteroscopies. Fertil Steril. 2008;89(2):438-43.
18. Erian MM, McLaren GR, Erian AM. Advanced hysteroscopic surgery training. JSLS. 2014;18(4):e2014.00396.
19. Buchholz J, Vollmer CM, Miyasaka KW, Lamarra D, Aggarwal R. Design, development and implementation of a surgical simulation pathway curriculum for biliary disease. Surg Endosc. 2015;29(1):68-76.
20. de Montbrun SL, Macrae H. Simulation in surgical education. Clin Colon Rectal Surg. 2012 ;25(3):156-65.
21. Samia H, Khan S, Lawrence J, Delaney CP. Simulation and its role in training. Clin Colon Rectal Surg. 2013;26(1):47-55.
22. Pena G, Altree M, Field J, Sainsbury D, Babidge W, Hewett P, Maddern G. Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop. Surgery. 2015;158(1):300-9.
23. Bhave Chittawar P, Franik S, Pouwer AW, Farquhar C. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2014;2014(10): CD004638.
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IssueVol 18, No 2 (June 2024) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v18i2.15929
Keywords
Surgical Training Non-Technical Skills Hysteroscopy Gynecologic Surgeons Surgical Competency

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How to Cite
1.
Jafarabadi M, Gorginzadeh M, Rezayof E. The Effect of a Short Training Course of Hysteroscopic Myoma Resection on the Non-Technical Skills of Gynecologic Surgeons. J Family Reprod Health. 2024;18(2):80-84.