{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:51:55Z","timestamp":1782816715293,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014735","name":"Royal College of Physicians and Surgeons of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Vaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present study was to investigate whether procedure\u2010specific simulation skills, vs usual training, result in improved operative competence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We completed a randomized controlled trial of didactic and procedural training via low fidelity vaginal surgery models for anterior repair, posterior repair (PR), vaginal hysterectomy (VH), recruiting novice gynecology residents at three academic centers. We evaluated performance via global rating scale (GRS) in the real operating room and for corresponding procedures by attending surgeon blinded to group. Prespecified secondary outcomes included procedural steps knowledge, overall performance, satisfaction, self\u2010confidence and intraoperative parameters. A priori sample size estimated 50 residents (20% absolute difference in GRS score, 25% SD, 80% power, alpha 0.05). <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link>: Registration no. NCT05887570.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We randomized 83 residents to intervention or control and 55 completed the trial (2011\u201323). Baseline characteristics were similar, except for more fourth\u2010year control residents. After adjustment of confounders (age, level, baseline knowledge), GRS scores showed significant differences overall (mean difference 8.2; 95% confidence interval [CI]: 0.2\u201316.1; <jats:italic>p<\/jats:italic>\u2009=\u20090.044) and for VH (mean difference 12.0; 95% CI: 1.8\u201322.3; <jats:italic>p<\/jats:italic>\u2009=\u20090.02). The intervention group had significantly higher procedural steps knowledge and self\u2010confidence for VH and\/or PR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, adjusted analysis). Estimated blood loss, operative time and complications were similar between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to usual training, procedure\u2010specific didactic and low fidelity simulation modules for vaginal surgery resulted in significant improvements in operative performance and several other skill parameters.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14810","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:55:05Z","timestamp":1708563305000},"page":"1165-1174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Procedure\u2010specific simulation for vaginal surgery training: A\u00a0randomized controlled trial"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-0842","authenticated-orcid":false,"given":"Roxana","family":"Geoffrion","sequence":"first","affiliation":[{"name":"Division of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole A.","family":"Koenig","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5777-7836","authenticated-orcid":false,"given":"Geoffrey W.","family":"Cundiff","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Flood","sequence":"additional","affiliation":[{"name":"Division of Urogynecology, Department of Obstetrics and Gynecology University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momoe T.","family":"Hyakutake","sequence":"additional","affiliation":[{"name":"Division of Urogynecology, Department of Obstetrics and Gynecology University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Schulz","sequence":"additional","affiliation":[{"name":"Division of Urogynecology, Department of Obstetrics and Gynecology University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin A.","family":"Brennand","sequence":"additional","affiliation":[{"name":"Division of Urogynecology, Department of Obstetrics and Gynecology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Lee","sequence":"additional","affiliation":[{"name":"Centre for Advancing Health Outcomes  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Singer","sequence":"additional","affiliation":[{"name":"Centre for Advancing Health Outcomes  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Todd","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Specialties, Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Accessed May 26 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