Impact of a low fidelity pelvic organ prolapse quantification model on resident education

Objectives: To assess the utilization of a three-dimensional model in teaching obstetrics and gynecology residents how to perform a POPQ examination. The goal is to evaluate the effectiveness of the teaching process by correctly performing a POPQ exam, identifying all the measured points, and identifying stages of POP.

Methods: The residents were administered a pre-test to evaluate their knowledge of pelvic organ prolapse, and how to perform the examination. They were then asked to perform a pre-intervention POPQ exam on a low-fidelity pelvic model and were scored using an OSATS assessment. Each resident then received a 5-minute hands-on standardized lecture on the POPQ including how to do the exam. After the teaching, the residents then repeated the POPQ exam and scored again using the same OSATS assessment. The residents were asked to fill out a post-test and a post-test survey at the end of the session.

Results: There was a statistically significant increase in the questionnaire score (median increase=3, 95% CI =2.5-5, p=.002) and POPQ score (median increase = 6, 95% CI = 3.5-6.0, p< .001). This increase was held for 1-2^nd year residents for questionnaire score (median increase = 4.5, 95% CI = 1.0-6.0, p=.009) and for POPQ score (median increase = 4.5, 95% CI = 4.5-7.5, p=.006). There was no similar significant increase for 3^rd- 4th-year residents (p=.184, and p=.054) but this was likely due to the small sample size of the group (n=5). The feedback comments received from the residents that the simulation model clarified components of POPQ exam, and how to efficiently perform it. They also requested that it would be repeated.

Conclusions: POPQ simulation training on a low-fidelity pelvic model has shown a significant improvement in the knowledge of pelvic organ prolapse and how to perform a proper POPQ exam among obstetrics and gynecology residents.