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. 2024 Sep;166(3):1121-1126.
doi: 10.1002/ijgo.15508. Epub 2024 Mar 30.

Reliability of the carousel simulator for assessing labor cervical dilation in medical obstetrics education

Carlos Izaias Sartorao-Filho  1   2 , Ana Luisa Varrone Sartorao  2 , Diogo Coutinho Terribile  2 , Angelica Mercia Pascon Barbosa  1 , Marilza Vieira da Cunha Rudge  1
Affiliations

Reliability of the carousel simulator for assessing labor cervical dilation in medical obstetrics education

Carlos Izaias Sartorao-Filho et al. Int J Gynaecol Obstet. 2024 Sep.

Abstract

Objective: To determine the reliability of the Carousel simulator in medical education for obstetric examinations. Cervical dilation examination training in pregnant women exposes patients to additional uncomfortable and health-risk procedures, a gold standard, and does not objectively evaluate the medical student's competence.

Method: We studied the reliability of training internship medical students in obstetrics. Participating students were assigned to take the examination of digital assessment of the cervical dilation on the simulator. Classes performed 12 consecutive randomly blind predetermined cervical dilation examinations using the Carousel simulator. The exact answer and the answer with certainty within ±1 cm were registered and analyzed. Incorrect or outlier answers were considered with a cutoff of ≥2 cm from the dilation. A dispersion graph for each centimeter of dilation simulation was constructed.

Results: Sixty-six medical obstetricians took part, performing 396 examinations. Thus, we observed 49 outliers (12.37%) in simulated assessments. According to the analysis, we did not observe outliers from dilation 1 to 4 cm; dilation 7 to 9 cm had a higher index of outlier measurements. We did not consider any dilation simulation dispersion graphic as a null correlation. A strong correlation was seen in the dilation 1 to 6 cm and the dilation 10 cm. The dilations 7, 8, and 9 cm showed a weak correlation.

Conclusion: The Carousel simulator model is a reliable method for student learning. The simulator is an essential study tool capable of reducing the embarrassment and possible harm caused by the excessive and repetitive number of in vivo digital vaginal examinations. Novel studies are proposed to improve the simulator device and method, mainly to estimate the adequate repetitions and training needed before in vivo practice.

Keywords: gynecology; labor; medical education; obstetrics; simulator.

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References

REFERENCES

    1. Sartorao Filho CI, Barbosa AMP, Rudge MV. The "Carousel": a new simulation model for assessing the female pelvic examination in medical education. Int J Gynecol Obstet. 2021. doi:10.1002/ijgo.13953
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