Introduction of a learning model for type 1 loop excision of the transformation zone of the uterine cervix in undergraduate medical students: a prospective cohort study
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We address the impact of applying loop electrosurgical excision procedure (LEEP) under direct colposcopic vision teaching to our undergraduates using a self-developed simulation model and a standardized assessment to evaluate the progress of learning.
The undergraduate teaching module was composed of a theoretical course on cervical dysplasia, colposcopy, electrosurgery and excisional procedures of the uterine cervix. This was followed by hands-on practical rounds. During the hands-on practice the students performed five “type 1” LEEP under direct colposcopic vision on the self-developed simulator. Based on specimen fragmentation and excision accuracy a score system was established. The students were asked to answer a course evaluation questionnaire.
The accuracy of the excisions showed a statistically significant improvement during the five training procedures (excision depth 7.34 ± 1.60–8.54 ± 1.67 mm, p = 0.0041; deviation from target cone thickness 0.88 ± 1.16–0.13 ± 0.94 mm, p = 0.0116). The fragmentation of the conus decreased (2.57 ± 1.26–1.29 ± 0.60 pieces, p < 0.0001). All this led to a general improvement of the LEEP score (2.59 ± 1.93–0.84 ± 1.03, p = 0.001). The student’s questionnaire revealed a subjective satisfaction and improvement of their knowledge in pathomechanism, diagnosis and therapy of cervical pathologies.
Undergraduate surgical training, in cervical excisional procedure, is a successful method in improving the students’ perception and management of cervical pathologies.
KeywordsSimulation training Teaching LEEP LLETZ Cone biopsy Colposcopy
The authors would like to gratefully acknowledge the language editing for Ghada Hamza.
FZT: project development, data collection and analysis, manuscript writing. JCR: review and editing. CG: data analysis, review and editing. SF: data collection, review and editing. IJ-B: review and editing. EFS: review and editing. AH: review and editing.
Compliance with ethical standards
The study was approved by the Ethics Committee of Saarland (no: 259/17)
Conflict of interest
We declare that we have no conflict of interest.
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