Using virtual-reality simulation to ensure basic competence in hysteroscopy

Area of Science:

• Medical simulation
• Surgical training
• Gynecological procedures

Background:

• Hysteroscopy is a complex gynecological procedure requiring specialized skills.
• Current obstetrics and gynecology training lacks an evidence-based program to certify fundamental hysteroscopy skills before patient procedures.
• There is a need for a standardized assessment to ensure basic competence in hysteroscopy.

Purpose of the Study:

• To develop a simulation-based test for hysteroscopy.
• To gather validity evidence for the developed simulation test.
• To ensure basic technical competence in hysteroscopy through simulation.

Main Methods:

• Utilized the HystMentor™ virtual-reality simulator.
• Evaluated module feasibility and clinical relevance with six experts.
• Conducted a pilot study and enrolled medical students, residents, and experienced gynecologists for testing.
• Assessed outcomes using simulator metrics and explored validity evidence from five sources.

Main Results:

• The simulation test demonstrated high inter-case reliability for most metrics (Cronbach's alpha ≥ 0.80).
• Significant performance differences were observed between medical students, residents, and experienced gynecologists (p < 0.05).
• Clinical experience positively correlated with simulator test scores (Pearson's r = 0.49, p < 0.001), with notable false positive and false negative rates.

Conclusions:

• A validated virtual-reality simulation-based test for hysteroscopy has been successfully developed.
• This test is designed for mastery learning, ensuring trainees achieve competency before supervised patient training.
• The simulation test provides a reliable method to certify fundamental technical skills in hysteroscopy.