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A novel model for resident training
Out of sight, top of mind
Basic tenets of Montessori training include learning activities in a
“prepared environment.” In PRIMER training, the Simulation Center is
outfitted every day with training materials to allow learners to develop
independence, advance and learn at their own pace, and know if they
have performed procedures correctly.
Generally, people are taught to be visual
learners, but much of what we do in OB/GYN
is by touch or feel and you can’t see what
you are palpating. It’s important to replicate
that in simulation training.
— Brian Brost, M.D.
Residents first learn procedures with specially developed transparent
models so they can see what they are doing before progressing to opaque
models. When residents attain a prescribed level of accuracy — 90 percent
for cervical examination skills, for example — they repeat the skill with
the model placed in a chamber, out of their sight and without visual cues.
“Generally, people are taught to be visual learners, but much of what
we do in OB/GYN is by touch or feel and you can’t see what you are
palpating,” says Dr. Brost. “It’s important to replicate that in simulation
training.”
Distractions such as bleeding, lubricants and the sound of a crying baby
are later added to prepare residents for realistic scenarios. At the end of
the two-week training program, residents achieve a high degree of
accuracy in procedures.
“When we developed the program and tested first-year residents six weeks
after completion of the program, they got 60 to 70 percent of labor cervical
examinations exactly correct (98 to 99 percent accuracy within 1 centimeter),
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