Journal of Surgical Simulation 2020; 7: 63 - 72

Published: 26 November 2020


Original article

Who should be teaching vaginal hysterectomy on a task trainer? A multicenter randomized trial of peer versus expert coaching

Christina M. Escobar, Dominique Malacarne Pape, Kimberly L. Ferrante, Meleen Chuang, Demian Szyld and Veronica Lerner
Corresponding author: Veronica Lerner, Obstetrics and Gynecology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block 632, Bronx, NY 10461, USA. Email:


Background: We studied performance on a simulator among senior residents performing vaginal hysterectomy by using an Objective Skills Assessments Test-Simulated Vaginal Hysterectomy (OSAT-SVH). The aim of this study was to determine whether there are differences seen in peer (resident to resident) coaching compared with expert (faculty to resident) coaching.

Methods: Participants were third- and fourth-year OB/GYN residents at two academic institutions, who had performed fewer than five vaginal hysterectomies as primary surgeon. After orientation, participants performed vaginal hysterectomy on a trainer while being coached by either an expert or a peer. The peer coach was a third-year OBGYN resident and was trained by the expert coach before enrollment of the study participants in a separate 3-hour training session.

Results: Participants were videotaped performing a second hysterectomy on the model without coaching. A blinded faculty reviewer rated the videotaped hysterectomy using OSAT-SVH. Mean Global Rating Scale (GRS) and procedure-specific checklist (PSC) scores were not statistically significant between the peer and expert groups: GRS 11.6 (SD, 4.5) versus 13.0 (SD, 5.5) (P = 0.59) and PSC 15.0 (SD, 4.4) versus 15.0 (SD, 5.1) (P = 1.0), respectively.

Conclusion: This study may provide evidence that a trained resident surgical coach could be as effective as a faculty instructor when teaching the steps of vaginal hysterectomy using a task trainer. Further studies are needed to confirm this finding and to assess if the development of these skills transfers to clinical care.


vaginal hysterectomy; simulation; teaching surgical skills; peer versus expert coaching; OBGYN residents; task training