A Homemade, Cost-Effective, Realistic Pelvic Exam Model.

Jessie Godsey, Ilya Kott, Adrienne Payden, Patricia Ward
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Abstract

Audience: This innovation is intended to instruct medical students, residents of all levels, and mid-level practitioners.

Background: Pelvic examinations are essential components to clinical practice but are challenging to teach, learn, and practice on live patients secondary to patient comfort because this is an invasive procedure.1 Resident physicians and medical students traditionally learn these methods through observation while actively working in their department or clinics.2 Simulation models can improve a provider's competency and confidence performing pelvic examinations which improve patient comfort and exam accuracy.3 One barrier to simulation training is the cost of the pelvic simulator models. A basic pelvic exam simulator costs $365.4 The cost is high, therefore limiting the availability of a simulation model accessible to residency programs across the country. This barrier to pelvic models was overcome by developing a homemade alternative for cervical examination and collection of screening swabs. The model created can be easily manufactured by students, residents, and faculty alike for less than $20 and approximately two hours of manufacturing time. A literature review was conducted to find similar products and other production methods for a pelvic examination model. No comparable models were found.This is a guide to utilizing supplies from a local dollar store combined with home recycling products and a few common crafting tools to create a realistic pelvic examination model.

Educational objectives: After utilizing this pelvic examination model, the learner will be able to: 1) demonstrate ability to perform a pelvic examination comfortably and safely, 2) demonstrate ability to obtain a cervical swab on female patients, and 3) show proficient understanding of female anatomy.

Educational methods: The pelvic exam model is utilized to effectively teach proper technique for pelvic examinations. This model can be utilized to teach medical students, incoming residents, and new mid-levels. Senior residents, experienced mid-levels, or attendings who are experienced in completing pelvic examinations can easily utilize this model to teach proper technique.

Research methods: The data for this study was collected from a single graduate medical education program in Detroit, Michigan. This was designed as a single blind survey where the reviewer's identities were kept anonymous from the data collectors. Surveys were collected from attendings, residents, mid-level providers, and medical students across specialties of emergency medicine, family medicine, obstetrics and gynecology.

Results: A total of 77 individuals tested the homemade model and compared it to a pelvic exam on a live patient as well as a commercial pelvic exam model. Survey results showed the low-cost homemade model was just as effective as a commercially manufactured model, with some respondents saying the DIY model was more effective and more realistic. Comparing the commercial models to the homemade model, 54 of the 77 participants had experience with a commercial model. In the survey when compared to a commercial model, 57% of the participants felt the examination was the same, and 31% indicated the homemade model felt more realistic.

Discussion: Overall, the homemade cost-effective model is comparable if not more realistic to more expensive commercial models. The main take away of this innovation, to remember it is possible to create cost-effective models for realistic, educational learning. This model has one limitation because it is not suitable for a bimanual examination, but it can be expanded to allow for bimanual examination.

Topics: Pelvic examination, cervical examination, creative simulation models.

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一个自制的,经济的,现实的盆腔检查模型。
观众:这项创新旨在指导医学生、各级住院医生和中级医生。背景:骨盆检查是临床实践的重要组成部分,但由于这是一种侵入性手术,因此在活体患者身上进行教学、学习和实践具有挑战性,其次是患者的舒适度住院医师和医学生传统上通过观察来学习这些方法,同时在他们的部门或诊所积极工作模拟模型可以提高提供者进行盆腔检查的能力和信心,从而提高患者的舒适度和检查的准确性模拟训练的一个障碍是骨盆模拟器模型的成本。一个基本的盆腔检查模拟器需要365.4美元,成本很高,因此限制了全国住院医师项目的模拟模型的可用性。通过开发一种自制的宫颈检查和收集筛查拭子的替代方法,克服了骨盆模型的这一障碍。创建的模型可以很容易地由学生、居民和教师制造,成本不到20美元,大约需要两个小时的制造时间。我们进行了文献综述,以寻找类似的产品和其他生产方法的盆腔检查模型。没有发现可比较的模型。这是一个利用当地一元店的用品结合家庭回收产品和一些常见的制作工具来创建一个现实的骨盆检查模型的指南。教育目标:在使用此盆腔检查模型后,学习者将能够:1)展示舒适安全地进行盆腔检查的能力,2)展示在女性患者身上获得宫颈拭子的能力,3)展示对女性解剖学的熟练理解。教学方法:利用盆腔检查模型,有效地传授盆腔检查的正确技术。此模式可用于教授医学生、新住院医师和新中级医师。资深住院医师、有经验的中级医师或有完成盆腔检查经验的主治医师可以很容易地利用这个模型来教授正确的技术。研究方法:本研究的数据收集自密歇根州底特律的一个研究生医学教育项目。这是一项单盲调查,审稿人的身份对数据收集者是匿名的。调查对象包括急诊医学、家庭医学、妇产科等专业的主治医生、住院医生、中级医疗服务提供者和医学生。结果:共有77人测试了自制模型,并将其与活体患者盆腔检查和商业盆腔检查模型进行了比较。调查结果显示,低成本的自制模型与商业制造的模型一样有效,一些受访者表示DIY模型更有效,更逼真。将商业模型与自制模型进行比较,77名参与者中有54人有使用商业模型的经验。在调查中,与商业模型相比,57%的参与者认为考试是一样的,31%的人表示自制模型感觉更真实。讨论:总的来说,自制的高性价比模型与更昂贵的商业模型相比,即使不是更现实,也是相当的。这项创新的主要收获是,要记住,为现实的教育学习创造具有成本效益的模式是可能的。这个模型有一个限制,因为它不适合手工检查,但它可以扩展到允许手工检查。主题:盆腔检查,宫颈检查,创造性模拟模型。
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