Journal of Surgical Simulation 2024; 11: 25 - 34

Published: 14 June 2024


Original article

Resident education in urogynecologic procedures through stepwise simulation: puerperium to prolapse

Nicole Wood, Cecile A. Ferrando, Vicki Reed and Erin Higgins
Corresponding author: Nicole Wood, 85 Seymour St, Suite 525, Hartford, CT 06106, USA. Email:


Background: Studies suggest that at the time of graduation most obstetrics and gynecology (OBGYN) residents cannot independently perform all Council on Resident Education in Obstetrics and Gynecology (CREOG)-recommended urogynecologic procedures. Lack of confidence in these procedures may be combatted with the use of simulation in education. This study aimed to describe and evaluate the success of a novel stepwise urogynecologic simulation pilot program developed to promote resident procedural confidence.

Methods: A novel urogynecology simulation curriculum was developed, with an aim to maximize resident investment in urogynecologic procedures and promote diversity of learning through the incorporation of interprofessional instructors. The simulation was built to follow a single patient via stepwise stations through urogynecologic procedures they might encounter in a lifetime. Participants (post-graduate year [PGY] 1–4 OBGYN residents) completed a survey prior to and following the conclusion of the simulation.

Results: Study participants included seven junior residents (70%; PGY1: n = 4, PGY2: n = 3) and three senior residents (30%; PGY3: n = 1, PGY4: n = 2). Statistically significant improvements were noted in resident confidence in performing the included procedures (P = 0.018), confidence in counseling about the procedures (P = 0.001), confidence in recognizing complications (P = 0.0007), preparedness in performing the procedures (P = 0.001), and likelihood they will perform the procedures in practice (P = 0.029).

Conclusions: This simulation curriculum encouraged improved confidence and technical competency in urogynecologic procedures in OBGYN residents through skills development in a comprehensive simulation. We hope this intervention may be widely implemented to bolster urogynecologic education.


simulation; resident education; urogynecology; medical education; gynecologic education