Effectiveness of a Labor Cervical Exam Model in Family Medicine and OB-GYN Residents.

Abstract

BACKGROUND AND OBJECTIVES: Labor cervical exam accuracy is an essential skill for family medicine and OB-GYN residents to master. To determine the effectiveness of simulation on labor cervical exam training, family medicine and OB-GYN residents were trained using a self-constructed PVC pipe-based cervical exam model during a short and intensive simulation workshop or "boot camp." METHODS: A task trainer was constructed that allows for the blind examination of cervical dilation and effacement. This model was used in the training of first-year family medicine and OB-GYN residents during an 8 day simulation course. A longitudinal comparison of pre- and post-training accuracy was performed. Using a cohort design, the post-training accuracy of first-year family medicine and OB-GYN residents (interns) was also compared to second-fourth year OB-GYN residents. RESULTS: Use of the model by interns (n=25) resulted in significant improvements in the accuracy of their assessments of cervical dilation, but not effacement, and decreased intra-rater variability. When compared to the second-fourth year residents (n=25) who received traditional training, but not simulation training, interns were significantly more accurate and showed less intra-rater variability in their assessments of both dilation and effacement immediately after training compared to their senior colleagues. CONCLUSIONS: Training with the cervical exam model improved interns' accuracy and precision immediately after an 8-day simulation course. Use of this model in resident education may aid in the early stages of training and benefit more experienced trainees by augmenting traditional clinical training.