Obstetric anal sphincter injury repair workshop for residents

Obstetric anal sphincter injury (ASI) is associated with significant morbidity We conducted an ASI workshop for 20 obstetrics and gynecology residents and assessed its impact. Our goal was to determine and enhance residents' knowledge using a multimedia presentation, hands-on simulator and tests. We comment on trends regarding residents' knowledge bases and their retention of the material.

The workshop consisted of a pretest, lecture with slideshow, DVD, and 20 simulator stations. The porcine tongue simulator represented the human perineum, bungee cord the anal sphincter and a laceration created in each tongue an obstetrical ASI. Faculty members supervised the residents' suture repairs. We analyzed responses from identical immediate posttests and delayed posttests.

Out of a possible 18 points, the average scores were: pretest 9.1 (SD 2.32), posttest 17 (SD 1.34; P < .001), and delayed posttest 15.1 (SD 1.52; P < .001). On a 10 cm visual analog scale (VAS) evaluating the helpfulness of this exercise, the average respondent marked 9.0 (SD 0.95). On a VAS evaluating the comfort level in repairing ASI, the average pre-simulator score was 3.9 (SD 3.13) and the average post-simulator score 5.2 (SD 2.96; P < .001).

Relevant structured workshops with simulators for ASI repair could help improve residents' background knowledge and skills in repairing such injuries.