A Novel Approach to Diagnostic and Operative Hysteroscopy Training: Hands-On Training With One-to-One Tutoring in...

Hysteroscopy is the gold standard technique for the evaluation and treatment of intrauterine pathology related to infertility, abnormal bleeding, and recurrent miscarriages. Hysteroscopy training is a fundamental part of training in gynecology. We report an innovative live-patient hysteroscopy training curriculum developed by the Second Department of Obstetrics and Gynecology of ''Aretaieion'' University Hospital of Athens, Greece.

The program includes a two-day course integrating both theory and hands-on sessions. The theoretical component encompasses pelvic anatomy, instrument-related physics, recognition of uterine pathology, indications of hysteroscopy, patient preparation, use of ultrasound, management of complications, and post-surgery care, promoting a deeper comprehension of limitations and applications of hysteroscopy. On the first day of practical training, trainees use hysteroscopic instruments in small groups in a dry lab under the supervision of experienced tutors. On the second day, they move on to live-patient cases for diagnostic and surgical hysteroscopy. Participants are exposed to a wide spectrum of surgical interventions ranging from simple diagnostic hysteroscopy to more advanced procedures such as International Federation of Gynecology and Obstetrics (FIGO) type 2 myomectomy or intrauterine adhesion management.

Post-course evaluation via a questionnaire has served as a valuable aid in the continuous improvement of the training program, in line with the ever-evolving field of hysteroscopic surgery. The overall satisfaction of the participants according to the self-reported 5-point verbal numeric rating scale (VNRS-5) was very high (mean score 4.8).

Our program addresses the lack of sufficient hysteroscopy training and offers an alternative to simulation-based training. Its curriculum is pioneering, combining theoretical as well as hands-on training with one-to-one tutoring in live patients, facilitating gynecologists to incorporate hysteroscopic procedures with more confidence into their surgical practice.