Journal of Education and Teaching in Emergency Medicine

ABSTRACT:Audience: This innovation is intended to instruct medical students, residents of all levels, and mid-level practitioners.

Background: Pelvic examinations are essential components to clinical practice but are challenging to teach, learn, and practice on live patients secondary to patient comfort because this is an invasive procedure.1 Resident physicians and medical students traditionally learn these methods through observation while actively working in their department or clinics.2 Simulation models can improve a provider’s competency and confidence performing pelvic examinations which improve patient comfort and exam accuracy.3 One barrier to simulation training is the cost of the pelvic simulator models. A basic pelvic exam simulator costs $365.4 The cost is high, therefore limiting the availability of a simulation model accessible to residency programs across the country. This barrier to pelvic models was overcome by developing a homemade alternative for cervical examination and collection of screening swabs. The model created can be easily manufactured by students, residents, and faculty alike for less than $20 and approximately two hours of manufacturing time. A literature review was conducted to find similar products and other production methods for a pelvic examination model. No comparable models were found.

This is a guide to utilizing supplies from a local dollar store combined with home recycling products and a few common crafting tools to create a realistic pelvic examination model.

Educational Objectives: After utilizing this pelvic examination model, the learner will be able to: 1) demonstrate ability to perform a pelvic examination comfortably and safely, 2) demonstrate ability to obtain a cervical swab on female patients, and 3) show proficient understanding of female anatomy.

Educational Methods: The pelvic exam model is utilized to effectively teach proper technique for pelvic examinations. This model can be utilized to teach medical students, incoming residents, and new mid-levels. Senior residents, experienced mid-levels, or attendings who are experienced in completing pelvic examinations can easily utilize this model to teach proper technique.

Research Methods: The data for this study was collected from a single graduate medical education program in Detroit, Michigan. This was designed as a single blind survey where the reviewer’s identities were kept anonymous from the data collectors. Surveys were collected from attendings, residents, mid-level providers, and medical students across specialties of emergency medicine, family medicine, obstetrics and gynecology.

Results: A total of 77 individuals tested the homemade model and compared it to a pelvic exam on a live patient as well as a commercial pelvic exam model. Survey results showed the low-cost homemade model was just as effective as a commercially manufactured model, with some respondents saying the DIY model was more effective and more realistic. Comparing the commercial models to the homemade model, 54 of the 77 participants had experience with a commercial model. In the survey when compared to a commercial model, 57% of the participants felt the examination was the same, and 31% indicated the homemade model felt more realistic.

Discussion: Overall, the homemade cost-effective model is comparable if not more realistic to more expensive commercial models. The main take away of this innovation, to remember it is possible to create cost-effective models for realistic, educational learning. This model has one limitation because it is not suitable for a bimanual examination, but it can be expanded to allow for bimanual examination.

Topics: Pelvic examination, cervical examination, creative simulation models.