Simulation in Gynecologic Surgery

Dr. Lerner is an Associate Professor at the Zucker School of Medicine at Hofstra/Northwell. She is on the Editorial Board of Obstetrics and Gynecology, and she is an associate editor for Simulation in Healthcare Journal.

The episode begins with Dr. Lerner describes her journey and training regarding simulation in gynecologic surgery, including her participation in the Center for Medical Simulation at Harvard and involvement in the American College of Obstetricians and Gynecologists Simulations Working Group, which are both involved in validating and advancing the use of simulation in healthcare. During this time, Dr. Lerner provides a framework for developing a simulation center at an institution, which begins with needs assessment and defining learning objectives. She also emphasizes the financial costs for simulation, as well as concern for institutions without adequate resources for simulation. She then defines 3 terms regarding fidelity: cost, technology, and actual fidelity. For example, Dr. Lerner has built her own mobile simulation lab, which she describes as a high-fidelity, low-cost initiative.

The physicians then discuss the role of individualized learning plans in regard to simulation. Dr. Lerner references the book, “Make It Stick,” to emphasize the importance of tailoring training to the learning strategy of the learner. She also encourages listeners to acknowledge the risk of moral injury and to combat it by acknowledging the difficulty that may come with developing competency in simulation. Lastly, she describes how listeners should leverage resources and time in order to promote simulation at individual institutions.

The episode ends with the group recognizing the benefits of simulation, as well as its relation to the field of Quality and Safety. While simulation in obstetrics is well-studied, its role in the field of gynecology has lagged due to lack of financial incentives. To address this, Dr. Lerner urges listeners to take advantage of surgical simulation in a safe environment prior to operating in the OR. During this discussion, Dr. Lerner expresses the importance of trainees to gain exposure to simulation early on and to develop an “education portfolio” over the period of residency. In order to help continue the information learned through simulation, it is important to “teach the teacher, train the trainer, and disseminate that knowledge.” Ultimately, Dr. Lerner advocates for the endless opportunity that simulation brings to the field of gynecology surgery.