Brief Report
Teaching Pediatric Straddle Injury Repair with Use of a 3D Printed Model

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ABSTRACT

Study Objective

To determine the utility of a 3D vulvar model for teaching pediatric straddle injury repair.

Design

Prospective study.

Setting

Two academic hospitals.

Participants

Twenty obstetrics and gynecology residents

Interventions and Main Outcome Measures

Knowledge score on the basis of a 7-question pre/post test. Likert scale questions evaluated the 3D model as a teaching tool.

Results

Twenty residents participated; 2 (10%) had ever repaired a straddle injury. Knowledge scores increased after model use and didactic session from 3.05 of possible 7 to 6.35; P = .001. Only 2/20 (10%) residents “agreed” or “strongly agreed” with the statement, “I am comfortable repairing a straddle injury” before the intervention, compared with 19/20 (95%) afterward (P < .001). Of 20 residents, 19 (95%) believed that it simulated surgical experience “very well” or “well.”

Conclusion

The use of a 3D pediatric vulvar model can simulate surgical experience and can be an effective teaching tool when combined with a didactic session on pediatric straddle injury.

Introduction

Pediatric straddle injury is the most common etiology of genital trauma in girls younger than the age of 14 years.1 A pediatric straddle injury is defined as a fall in which the subject straddles an object compressing the soft tissue of the vulva between the object (eg, arm of a chair, bicycle crossbar, playground equipment) and the underlying bones of the pelvis.2 These injuries typically occur between the ages of 2 and 6 years and most commonly involve the external genitalia, vestibule, perineum, or posterior fourchette.1,2

Many genital injuries can be managed conservatively, but some will need surgical care. Pediatric straddle injury repair is technically similar to that of a first- or second-degree repair after vaginal delivery in adult women, however, the approach, surgical tools, and anatomic proportions are different. It is important for obstetrics and gynecology (OBGYN) resident physicians to be trained in the history, examination, and surgical technique of a pediatric patient with a straddle injury.

Because of the rarity of this type of trauma, residents might not receive this surgical experience during their 4 years of OBGYN training. Currently, there are no tools available to teach the examination and repair of pediatric straddle injuries; however, printed 3D models have been used in other areas of medical education.3., 4., 5. Three-dimensional printing can develop surgical models that have the same tactile feel as normal tissue. The purpose of this study was to evaluate a 3D pediatric vulvar model for teaching pediatric straddle injury repair among OBGYN residents. The model was used during a scheduled didactic session on pediatric straddle injury.

Section snippets

Materials and Methods

This was a prospective study on the use of a 3D pediatric vulvar model along with a didactic presentation on pediatric straddle injury repair. Two academic institutions were included that are geographically similar and both have structured didactic sessions for resident education. Both institutions have attendings with expertise in pediatric and adolescent gynecology (PAG). One academic institution had a 3D printer within the department of graphic design that had been used for other surgical

Results

Of the 32 potential residents at both institutions, 20 residents attended their scheduled didactic session, and of those, all accepted to participate in the research study. Residents not completing the study were on night rotations or not present during the scheduled didactic session. Residents were distributed across training levels with 7 postgraduate year (PGY)-1, 3 PGY-2, 6 PGY-3, and 4 PGY-4 participants. Only 2/20 (10%) residents, 1 PGY-3 and 1 PGY-4, reported ever performing a pediatric

Discussion

The use of a 3D pediatric vulvar model can simulate surgical experience and was overall reported to be an acceptable tool when combined with a didactic session on pediatric straddle injury.

Use of 3D printed surgical models have been used in other fields for teaching various skills. Within one of the institutions, 3D models were previously used to simulate abdominal hysterectomy because of the decreasing prevalence of open surgical cases.6 The benefit of 3D models is that they provide hands-on

References (6)

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Cited by (0)

The authors indicate no conflicts of interest.

This work was presented, in part, as a virtual podium presentation at the North American Society for Pediatric and Adolescent Gynecology Annual Clinical and Research Meeting on June 21, 2020.

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