Training Model for Intrauterine Device Insertion

ABSTRACT

Introduction  Learning by practicing exclusively on patients is becoming increasingly unacceptable in medical training. Simulation-based teaching is a tool capable of generating skills and competences efficiently and in a controlled environment, without causing harm to patients. Gynecology is a medical specialty that depends on well-structured training; an important gynecological procedure is the insertion of copper intrauterine devices. In order to increase the supply of this contraceptive method to the population the relevant health professionals need to be adequately trained. Physical simulators imitate reality and assist in skills acquisition. Therefore, structured training based on simulation to teach the insertion of intrauterine devices is of fundamental importance to the teaching of gynecology.

Objective  To develop a training model for skills acquisition for the insertion of intrauterine devices.

Method  A simulator (utility model) was developed for the insertion of intrauterine devices, composed of a rigid rectangular base made of acrylonitrile butadiene styrene, measuring 17 cm x 15 cm x 21 cm and weighing 420 g. Attached to this support is a semi-flexible structure made of flexible polylactic acid, composed of a prototype vaginal canal, with a uterine cervix and vulvar region, similar to the human anatomy. Fifteen gynecology and obstetrics residents were selected for theoretical and practical training with the simulator proposed by the study for the training of intrauterine copper device insertion. The simulator used in this study was evaluated by specialists in gynecology and obstetrics, who validated it for use in teaching.

Results  A statistically significant improvement was found in the evaluated parameters, comparing the initial evaluation and the final evaluation of the residents, whose final performances displayed homogeneity. In the initial evaluation only 40% of the devices were well positioned, in contrast to a 93.3% rate of successfull insertion following implementation of the training model.

Conclusion  A training model was developed to simulate the performance of copper intrauterine device insertion and contributed to the acquisition of skills for this task when applied to gynecology and obstetrics residents.

Medical Education; Simulation; Intrauterine Devices