Teaching Vaginal Surgery Through Simulation

Area of Science:

• Medical Education
• Surgical Simulation
• Gynecologic Surgery

Background:

• Declining surgical volumes limit resident training opportunities in vaginal surgery.
• Simulation is being integrated into curricula to address this training gap.
• This review focuses on simulation training for gynecologic vaginal surgical procedures.

Purpose of the Study:

• To conduct a scoping review of literature on simulation training for gynecologic vaginal surgical procedures.
• To identify and summarize existing educational methodologies, assessment tools, and implementation factors.
• To highlight information for surgical educators implementing simulation in vaginal surgery skills.

Main Methods:

• A comprehensive literature search was conducted, yielding 5,560 articles.
• Data extraction focused on model description, objectives, skills, outcomes, and assessment metrics.
• 41 studies were included, covering vaginal hysterectomy, prolapse surgery, incontinence sling procedures, and fistula repair.

Main Results:

• Significant heterogeneity exists in simulation fidelity, complexity, cost, and educational effectiveness.
• Few studies reported proficiency cutoff scores or robust validity evidence.
• While practical considerations were addressed, skill transfer to the operating room and patient outcomes were rarely evaluated.

Conclusions:

• The literature demonstrates innovation but also considerable variation in simulation-based vaginal surgery training.
• Standardized assessment tools and improved validity evidence are needed.
• Further research should evaluate the translation of simulation skills to surgical competency and patient care.