Conisation course for medical students-experience from a German University Hospital

Conisation of the cervix is one of the most common surgical procedures in gynaecology. Nevertheless, surgical expertise is required because if the cone is too small, the oncological risk increases and if the cone is too large, the obstetric risk increases. The aim of this prospective study was to investigate the suitability of an in-house conisation simulator for teaching medical students the practical performance of conisation.

Following a demonstration, students performed a loop conisation with a target depth of 8-10 mm using the simulator. Cone biopsy dimensions were analysed and a loop electrosurgical excision procedure (LEEP) score was calculated. The students were surveyed using a questionnaire of 12 items with five possible responses for each in order to investigate the suitability and realism of the teaching experience.

Eighty-nine students participated in the course. The median (range) cone depth was 8 (3-25) mm with a standard deviation of 3.3 mm. The observed LEEP score amounted to 1.5. The questionnaire was answered by 88 students and completed by 86. Survey results showed the course was consistently rated as positive, especially towards the increase in practical skills. The questionnaire item producing the highest score was “I enjoyed the course” while the statement “I have gained enough self-confidence for the application of high-frequency surgery” received the lowest approval score. Students considered the course to be realistic and a helpful teaching exercise.

Practical surgery exercises on the surgical simulator were received positively. Simulation training could be extended to other gynaecological operations and to other medical subjects.