Effectiveness of a novel low-cost pelvic organ prolapse quantification system simulation model

The pelvic organ prolapse quantification system (POP-Q) is an objective, site-specific system used to describe, quantify, and stage pelvic support. At the completion of obstetrics and gynecology residency, residents are expected to be able to assess for prolapse. However, resident exposure to the POP-Q during training varies. Despite simulation being recognized as a crucial component of residency education by the American College of Obstetrics and Gynecology (ACOG), there is no POP-Q simulation. The objective of this study is to determine if our simulation model is effective in teaching residents the POP-Q. This was a prospective survey-based cohort study performed at a single ACGME accredited obstetrics and gynecology residency program. IRB exemption was obtained. Residents of all years were included. A planned simulation was led by a single urogynecology fellow using a script for standardization. Residents were educated on the POP-Q through a simulation using our novel low-cost, low-fidelity model. Three different levels of support were simulated (figure 1). Residents completed an anonymous electronic pre- and post-simulation survey utilizing a five-point Likert scale on experience, simulation, and POP-Q ability. Descriptive statistics were performed as well as Wilcoxon rank-sum. Video of this simulation model may be viewed in the SGS video library: “A Simulation Model for the Pelvic Organ Prolapse Quantification System (POP-Q)”. 24 residents participated: 12 beginner (50%, post graduate year (PGY) 1 and 2) and 12 advanced (50%, PGY 3 and 4) learners. Of the participants, 71% had some clinical urogynecology experience and 29% reported no urogynecology experience. No residents reported having participated in a POP-Q simulation, despite 95% reporting they would have preferred simulation over learning by reading, lectures, and patient care. Pre-simulation, 68% of respondents reported finding the POP-Q either extremely or somewhat difficult, with no residents reporting it as extremely easy. There was significant improvement in resident reported confidence in performing, comfort with conceptualizing, and ability to explain the POP-Q (p .0003, .001, and .002 respectively). There was no difference pre and post in whether residents find simulation helpful, which shows residents appreciate simulation learning (p .32). Overall, residents felt that they benefited from the model. This novel low-cost POP-Q simulation model was found to be an effective teaching method by residents of all levels.