UW Obstetrics and Gynecology
Women and Infants Simulation and Education Lab

Redefining ‘hands-on learning,’ the Department’s Women and Infants’ Simulation and Education Lab, located at Meriter Hospital, continues to add new curricula to its high-tech surgical simulation program. Cutting edge simulation equipment uses video and 3D animation, as well as computerized scoring, to provide an invaluable surgical simulation experience to medical students, residents and faculty in the Department of Ob-Gyn. Medical students practice infant delivery and the basic skills of suturing and knot-tying, while residents and faculty use the Sim Lab to practice and perfect complex obstetrical emergency surgeries and laparoscopic procedures. "The time that we spend in the simulation lab builds our confidence in our skills and makes us more knowledgeable about procedures so that when we are dealing with a real, live patient we have already practiced our skills. The simulation lab is a wonderful tool for the residents," 2012 Alumni resident Christine Trautman said.

Moving toward a goal of interdisciplinary simulation exercises in real-time, the last year saw the Sim Lab expand to include training for several specialties. Pediatric residents practice neonatal resuscitation; while UW nurses and anesthesiologists at Meriter Hospital have collaborated with the Department in training for obstetric emergency procedures.

A Hands-on Training Experience

The old adage teaches the practice makes perfect, and residents in the Department have plenty of opportunities to practice. The Department's Women and Infants Simulation and Education Lab gives residents the opportunity to practice their surgical skills outside of the operating room and delivery rooms.

Four years ago, the Department established the Simulation Lab in space donated and remodeled by Meriter Hospital. John Street, the department's Education Program Manager, manages the Lab. With generous support from the Ob/Gyn department and Meriter hospital, Dr. Ellen Hartenbach established the lab on 5 East at Meriter. According to Street, she's the driving force behind the success of the Simulation Lab. The current Director of the Simulation Lab is Dr. Brent Dumemuth.

"For most simulation labs, the easy part is buying the equipment. The really difficult part is cutting residents and faculty free from clinical duties to attend the Lab's training sessions," Street said. "Thanks to the leadership of Dr. Laurel Rice and Dr. Hartenbach and strong support from the faculty, this has not been a problem in our four-plus years of operation."

According to current residents, the hands-on training that they receive in the Simulation Lab is invaluable. "The time that we spend in the Simulation Lab builds confidence in our skills and makes us more knowledgeable about procedures so that when we are dealing with a real, live patient we have already practiced our skills."

The Lab is equipped with a maternal-infant simulator that the residents have nicknamed Noelle. The simulator imitates a delivery scenario, and software can be programmed to run delivery complications so residents learn to cope with situations as they arise. In the Lab, residents use actual instruments to practice their laparoscopic surgical skills.

"It's a difficult skill to master because when you are doing laparoscopic surgery you are looking at a video image and not directly at your work. People just aren't used to work that way," Street said.

The residents also practice skills in the Simulation Lab that they might not have a lot of exposure to in the operating room. The Abdominal Hysterectomy Lab epitomizes the value of simulation to our residents. Since our department performs laparoscopic surgery when possible because it is much less invasive, causes less pain for the patient, and provides quicker recovery times, our residents have fewer opportunities to experience abdominal hysterectomies.

To ensure that residents are sufficiently prepared to perform an abdominal hysterectomy, Dr. David Kushner and Dr. Heather Einstein developed a comprehensive abdominal hysterectomy training session. Several faculty members are there to share their experience and guide the residents' work.

"We pair up a senior resident with a junior resident so that the less experienced residents get the benefit for working with someone who has already done numerous procedures in the operating room," Street said. "The repetition is also a benefit to have the senior resident because the best way to reinforce your own learning is to teach it to someone else."

The Simulation Lab increases the confidence residents have in their skills and knowledge. It also increases the confidence faculty have in residents. This creates a positive ripple effect. Faculty are more apt to allow residents to do procedures earlier in their training, which helps residents develop a higher skill level by the time they graduate! Residents also receive their won pass cards to the Simulation Lab so that they can continue to practice their skills at any time, day or night.

Class Schedule for 2016-2017

Fundamentals of Laparoscopic Surgery (FLS)
PGY1 residents: Introduction to and practice of basic laparoscopic skills.

Hysteroscopy
PGY1-2 residents: Learning set up, proper technique and potential complications of the hysteroscopy procedure.

Laparoscopic Entry and Exit
PGY1 & PGY2's: Review and practice of techniques and instruments for proper laparoscopic entry/exit.

Laparoscopic Single Port Entry
Learn and practice the proper technique for effective single port laparoscopic surgery.

Robotic Surgery Simulation in OR
PGY3 & 4’s: Practice on DaVinci robot in Meriter OR.

Shoulder Dystocia
All residents: Practice on Noelle of proper technique for shoulder dystocia.

Abdominal Hysterectomy
All residents: Practice proper Abdominal Hysterectomy technique on simulation models.

Obstetric Emergency Drills
All residents: Work in teams to perform OB emergency drills on labor and delivery floor.

Obstetric Blood Loss
All residents: Learn techniques for accurate estimate of blood loss in Postpartum Hemorrhage.

Laparoscopic Suturing
All residents: Develop laparoscopic suturing skills under faculty supervision.

Vaginal Hysterectomy
All residents: Practice proper Vaginal Hysterectomy technique on simulation models.

Anatomy Lab
All residents: Study of pelvic anatomy using 3D models and videos.

FLS Testing
PGY1 residents: Complete timed laparoscopic skill tests, including laparoscopic suturing.

Simulation Manager

John Street, PhD
John Street
Education Program Manager

jpstreet@wisc.edu
202 S. Park (Meriter)
Madison, WI 53715