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    Simulation builds skills

     

    Dr. Levine is a clinical fellow at the Ronald O. Perelman & Claudia Cohen Center for Reproductive Medicine at the Weill Cornell Medical College at New York Presbyterian Hospital.

     

     

    Dr. Goldschlag is an assistant professor of Clinical Obstetrics and Gynecology and Assistant Professor of Clinical Reproductive Medicine at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at the Weill Cornell Medical College at New York Presbyterian Hospital.

     

     

    In 1999, the Institute of Medicine (IOM) issued the report To Err Is Human. In it, the IOM’s Committee on Quality of Health Care in America stated that not only did preventable medical errors cause more deaths than such feared threats as motor-vehicle accidents, breast cancer, and AIDS, but also that errors with serious consequences were most likely to occur in intensive care units, emergency departments, and operating rooms.1 Although some operating room-associated complications can be attributed to wrong-site surgeries and equipment malfunctions, countless patients are harmed because of physician skill deficiencies.

    It is sad but true that many ob/gyn residents are still trained using a Halstedian approach that can be boiled down to the infamous "See one, do one, teach one." Contrary to this philosophy of surgical education, surgery is not something that is  best taught by seeing, or best mastered by attempting on live subjects. There is an unavoidable practical element to effective surgical education, but no patient wants to be the “one" for a resident attempting to master a surgical procedure, especially in a fast-paced, high-stress clinical learning environment.

    Even though surgery is a key part of ob/gyn training, a survey of residency programs found that only 74% formally evaluate surgical skills, with the majority reporting subjective faculty evaluations as the primary method of assessing skill proficiency. This occurs despite the availability of thoroughly vetted measures such as the objective structured assessment of technical skills (OSATS), the observational clinical human reliability assessment (OCHRA), and the operative performance rating system (OPRS).2

    Brian A. Levine, MD, MS, FACOG
    Dr. Levine is Practice Director at the Colorado Center for Reproductive Medicine, New York, New York.
    Dan Goldschlag, MD, FACOG
    Dr. Goldschlag is an assistant professor of Clinical Obstetrics and Gynecology and Assistant Professor of Clinical Reproductive Medicine ...

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