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Beef tongue as educational model to improve midwife skill in fourth-degree laceration repair

Presenting Author(s)

Diana Q. Vazquez Parker, MD (she/her/hers)

Resident Physician
Jamaica Hospital Medical Center
Queens, New York, United States

Co-Author(s)

LZ

Linlin Zhou, MD

Resident
Jamaica Hospital Medical Center
Queens, New York, United States
JA

Janice Ascencio, MD

Attending Physician
Jamaica Hospital Medical Center
Queens, New York, United States
PF

Patricia Fox, CM (she/her/hers)

Certified Midwife
Jamaica Hospital Medical Center
Queens, New York, United States
NC

Nuan Cui, MD (she/her/hers)

Attending Physician
Jamaica Hospital Medical Center
Queens, New York, United States

Objectives: This study aims to explore the improvements in understanding of pelvic anatomy and confidence for laceration repair of CNM/CM surveyed both prior and after a beef tongue workshop intervention.

Methods: A group of eleven CNM/CM from a non-profit teaching hospital participated in a two-hour long fourth-degree laceration combined lecture and simulation activity with simplified beef tongue models, based on a previous model trialed with Obstetrics and Gynecology (OBGYN) residents from the same hospital. Our model utilized both portions of beef tongue and chicken breast to mimic the different pelvic musculature (Figure 1). The inferior portion of the tongue was cut into strips and sutured within the pseudo-laceration to create an external anal sphincter. A chicken breast was dissected into flat pieces and sutured to the base to represent the rectal mucosa. The workshop utilized both OBGYN and Urogynecology attending physicians and senior OBGYN residents as preceptors. A Likert type questionnaire was developed including four items that assessed technical skills and comfort levels before and after the session.

Results: All CNM/CM responded positively with use of the models and showed improvement in their understanding of pelvic anatomy and laceration repair techniques (Figure 2). Learners demonstrated an interest in participating in future simulation activities to augment their clinical skills.

Conclusions: Our results suggest that the simplified beef tongue model was an accessible and effective way to improve trainee confidence with perineal anatomy and repairing fourth degree lacerations.