PURPOSE
Second-degree perineal tears occur in 40% of births. Due to this common
occurrence, residency programs incorporate perineal tear repair simulation
models into their training. Programs typically rely on sponge models for
suture practice. However, realism and reusability are major limitations to
this model. The purpose of this study was to develop a silicone-based
perineal tear model in collaboration with clinicians, medical illustrators, and
medical educators at the Medical College of Georgia (MCG).
METHODS
A silicone-based second-degree perineal tear repair model was developed.
Silicone was selected for its durability and realistic texture. The creation
of the silicone insert employed a layered construction with varying textures
to represent anatomical structures, including skin, external genitalia, and
perineal musculature. The silicone inserts fit into a custom 3-D printed
stand to allow for suturing in different orientations. Preliminary evaluation
of model texture, consistency, reusability, and applicability were assessed
using a pre- and post- survey administered to residents at MCG during a model
workshop.
RESULTS
Sixteen OBGYN resident completed the pre- and post- survey during the
session. Questions regarding the residents’ confidence with metrics such as
identifying anatomical layers, closing mucosal lacerations, and locating the
apex of a laceration were assessed. Confidence across all metrics
significantly improved (p<0.05). Residents noted the model was superior to
other models. Feedback included developing a locking mechanism, more flexible
material, and variations in laceration location, shape, and depth.
CONCLUSIONS
Initial feedback suggests the perineal tear model offers a realistic and
educationally valuable alternative to traditional models. Feedback will be
used to refine the model. Ongoing evaluations will assess texture,
appearance, reusability and other metrics as the model continues to be
assessed by attending physicians and medical students.