Obstetrics & Gynecology Residency Simulation Training | NYU Langone Health

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Obstetrics & Gynecology Residency Obstetrics & Gynecology Residency Simulation Training

Obstetrics & Gynecology Residency Simulation Training

The Obstetrics and Gynecology Residency Simulation Training program in NYU Langone’s Department of Obstetrics and Gynecology is led by Christine L. Proudfit, MD.

Our residents and staff have access to the simulation curriculum they need to grow and improve as specialists. This curriculum complements our clinical, research, and didactic training. We are continually collecting and reviewing feedback on our simulation courses and collaborating with outside institutions on our offerings because a nationally recognized simulation curriculum does not currently exist.

Safe Entry in Laparoscopic Surgery Online Learning Module

All department faculty and residents must take this online course, which includes a didactic overview, surgical videos, and a case-based approach to safe entry in laparoscopic surgery.

Colposcopy and Management of Abnormal Cervical Cytology and Histology

Our course on colposcopy and management of abnormal cervical cytology and histology helps residents master the complex algorithms used to manage abnormal Pap tests and colposcopic biopsy results. Users explore the difficulty of applying algorithms to specific cases, the need for multidisciplinary collaboration, and the complexity of constantly evolving guidelines. The course consists of the sessions below.

Small Group Session During Ambulatory Care Rotation

The small group session, which takes place during ambulatory care rotation, allows residents to actively participate in clinical decision-making under direct attending supervision. Three residents, a second-year, third-year, and fourth-year, meet with a different faculty member each week to review one article chosen by the group from a reading list, a curriculum organized by Jessica S. Rose, MD. After this short journal club, the residents and faculty leader review charts of patients who are coming in for colposcopy clinic appointments that week. These reviews are used to make further clinical management decisions.

Case-Based Multidisciplinary Conference

All residents, one or more obstetrics and gynecology faculty members, pathology faculty, cytopathology fellows, gynecologic oncologists, and gynecologic oncology fellows review three cases chosen for teaching purposes. Dr. Rose runs this monthly conference and facilitates case selection and discussion.

Robotic-Assisted Laparoscopy

Our five-part course on robotic laparoscopy helps residents become “robot ready,” in compliance with patient safety standards. Residents receive exposure to the large case volume necessary to become skilled in robotic surgery. Unlike traditional surgery and the assistant–apprentice model, robotic surgery requires additional specialized training in the use of complex technology before a surgeon can operate independently. Trainees who complete this pathway are able to sit at the console and operate in major cases.

The course consists of a self-directed didactic component developed by Intuitive, manufacturers of da Vinci® robotic surgical systems, that includes an online module and a reading list. Also included are two hands-on operating room dry labs. The first includes docking and undocking the robot and bedside assist skills; the second addresses the console. Each lab is three hours long, for a total of six hours.

Training also includes proctored experience with bedside assisting at the patient cart to solidify knowledge of laparoscopic spatial awareness, robotic docking, instrument exchanges, and troubleshooting. Residents also complete a self-directed series of virtual reality simulation modules using the da Vinci® robotic trainer. Logging cases and faculty evaluations enable trainees to maintain competency.

Comprehensive Simulation Training Program

Our comprehensive simulation training program consists of an intern boot camp and several three- to four-hour simulation sessions per academic year. Some sessions repeat on an annual basis and others rotate as part of a two-year curriculum.

Monthly in situ simulation sessions on labor and delivery take place at NYC Health + Hospitals/Bellevue and NYU Langone Hospital—Brooklyn, run by Sepideh Mehri, MD. Sessions at NYU Langone’s Tisch Hospital are led by Christine L. Proudfit, MD. The curriculum addresses surgical and procedural skills, team-based training for emergencies, and simulated patient encounters for complex medical and communication topics.

Annual Intern Orientation (Intern Boot Camp)

Our intern boot camp consists of five three- to four-hour sessions for two weeks in June before the first year of residency training starts. The orientation focuses on surgical skills and procedures and includes hands-on, clinically oriented simulation incorporating basic didactics at the following stations: obstetric ultrasound; gynecologic ultrasound (led by a task trainer); suturing and knot tying; perineal laceration repair; laparoscopic skills (using box trainers); neonatal circumcision; cervical exams; placement of fetal scalp electrode and intrauterine pressure catheter (labor management); cesarean delivery; long-acting reversible contraception placement; and knowledge of surgical instruments, sutures, and techniques.

Annual Colposcopy and Loop Electrosurgical Excision Procedure

Taking place in July, this session for first-year residents focuses on surgical skills and procedures, names of colposcopy instruments, loop electrosurgical excision procedure, and administration of paracervical block, with hands-on, clinically oriented simulation incorporating basic didactics into each station.

Annual Hysteroscopy Lab

The hysteroscopy simulation lab provides first-year residents with hands-on training combined with didactic sessions covering diagnostic and operative hysteroscope assembly, bipolar resectoscope with fluid management (green pepper model); hysteroscopic morcellators (TruClear, plastic model); and cystoscope assembly and cystoscopy performance.

Annual Energy Sources in Laparoscopy

A combination of hands-on training and didactic training, our annual energy sources in laparoscopy session is for all residents and covers monopolar and bipolar energy sources, ultrasonic energy sources, morcellators, and safety concerns and appropriate use.

Annual Laparoscopy Lab

The preceptors for this lab are faculty experienced in laparoscopy. We offer the lab at least four times a year, with one residency class attending each time. Residents receive laparoscopic training to simulate the following procedures: laparoscopic entry into the abdomen; salpingectomy and salpingostomy; cystectomy; opening the pelvic sidewall and potential spaces; radical dissection and ureterolysis; pelvic lymph node dissection; hemorrhage control; and laparoscopic suturing. This lab is hosted by Columbia University Irving Medical Center.

Annual Anatomy Lab

The materials and handouts for this annual session, which was created for all residents, are continually updated to help guide surgical dissection, identify and review all pelvic and abdominal anatomy relevant to gynecologic surgery, and clinically correlate this anatomy with steps of the procedures and surgical complications. The simulation takes residents through pelvic dissection with emphasis on core procedures, with instruction from gynecologic oncology and female pelvic medicine and reconstructive surgery faculty and fellows. The goal of the session is for residents to observe the pertinent anatomy and perform radical gynecologic and advanced pelvic surgical procedures in a low-risk setting.

Biannual Dry Lab Session for Basic and Advanced Laparoscopy Skills

The dry lab session, which is offered twice a year, is primarily for third-year residents and covers basic and advanced open and laparoscopic skills adapted from the Society of American Gastrointestinal and Endoscopic Surgeons’ Fundamentals of Laparoscopic Surgery (FLS) curriculum for gynecologic surgery. The course includes skills in hand–eye coordination, laparoscopic cystectomy, and laparoscopic suturing and knot tying. The course is facilitated by the Surgical Skills Laboratory, part of NYU Langone’s Department of Surgery, under the guidance of Peggy Gluszak, RN, who is also an FLS trainer.

Annual Advanced Surgical and Obstetric Skills

Senior-level residents participate in sessions focused on advanced gynecologic surgical skills and procedures, such as abdominal hysterectomy and vaginal hysterectomy (using low-fidelity models). Experienced generalist faculty and female pelvic medicine and reconstructive surgery faculty facilitate these sessions.

Multidisciplinary, Team-Based, Clinical Training Sessions

Obstetrics and gynecology residents, nurses, and anesthesia residents working on labor and delivery participate in these special sessions, which cover postpartum hemorrhage; shoulder dystocia; vaginal breech delivery; pre-eclampsia, hypertensive crisis, eclampsia, and management of magnesium sulfate toxicity; operative delivery; maternal code (conducted with NYU Langone’s Department of Anesthesiology, Perioperative Care, and Pain Medicine); and intrauterine fetal demise.

Clinical Training Sessions

Simulation is an ideal context for learning communication skills, particularly in complex and challenging clinical scenarios. Our clinical training sessions, which often incorporate standardized patients, include intrauterine fetal demise, conducted with a perinatal bereavement team; surgical consent; periviability, conducted with the Neonatology Program in the Department of Pediatrics; aneuploidy screening; and mock deposition in collaboration with a legal team.