Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Lau KW(1), Cheung V (2)
Affiliation :
(1) Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, (2) Multi-Disciplinary Simulation & Skills Centre, Queen Elizabeth Hospital
Introduction :
Hysteroscopy is commonly used to assess and treat lesions of the uterine cavity. It is regarded as a painful procedure necessitating full anaesthetic support. “No touch” vaginoscopy technique was developed as one of the ways to reduce procedural-related discomfort, making an office hysteroscopy possible. It also provides an alternative option for endometrial access for patients who are never sexually active, without anaesthetic risks. As there is a lack of high fidelity / computer-based simulation models for vaginoscopy, gynaecologists traditionally to start vaginoscopy training on patients who are on general anaesthesia to gain experience before performing on fully conscious, non-anaesthetized patients. To reduce the non-indicated vaginoscopy practice of patients on general anaesthesia, the Vaginoscopy Task Simulator (VTS) was developed with the Vaginoscopy Task Simulator Scale (VTSS) to promote a standardized training on vaginoscopy.
Objectives :
1. To develop a simple and high-fidelity simulator for hysteroscopy, that can be continuously modified to simulate different levels of complexities.
2. To develop a simulator scale (VTSS) to objectively define and assess the cognitive, psychomotor and functionality domains of vaginoscopy.
Methodology :
A silicone simulator was made by casting silicone over a 3D-printed mold. The simulator was placed in a pneumatic cuff to simulate the natural elastic apposition of the vagina and cervix. Participants with various years of hysteroscopy experience went through the VTSS with the trainer and were allowed to self-practice. The participants were then assessed by the trainer across various domains of the VTSS. A questionnaire was given to the participants to evaluate their feedback on the vaginoscopy simulator and its relevance to the VTSS.
Result & Outcome :
The total cognitive domain score was 23.07 out of 25 (93%), indicating that the vaginoscopy task simulator could consolidate participants' memory on how to prepare vaginoscopy procedures. The total psychomotor domain score was 42.36 out of 45 (94%), indicating that the vaginoscopy task simulator could strengthen participants' practical knowledge and technical skills in 9 vaginoscopic insertion steps. The total functionality score was 18.71 out of 20 (94%). The result demonstrates that, through training with the vaginoscopy task simulator, participants would be able to enhance vaginoscopy technique effectively. In conclusion, the vaginoscopy simulator is a simple and effective tool to enhance the training and thus promote the use of vaginoscopy to improve care in patients requiring hysteroscopy. More versions of the simulator could be made to incorporate the simulation to standard hysteroscopy training for all gynaecologists.
