Decisions and Consequences: Validation of High-Stakes Simulation-Based Assessments in Gynecologic Surgery.

Study Objective: Simulation-based assessment is poised for application in educational promotion and credentialing in gynecologic surgery. With high-stakes assessment, validation necessitates evidence, not just about the trustworthiness of decisions but of beneficial consequences to education and healthcare as well. In this paper, we unpack the modern conceptualization of validity as it pertains to surgical simulation and high-stakes competency assessment.

Opioid Pain Medication Use in New Urogynecology Patients.

Objectives: The aim of this study was to determine the prevalence of opioid pain medication use among patients presenting for a new visit to the urogynecology clinic compared with those presenting to general gynecology.

Methods: We identified all patients who presented for new patient visits to the urogynecology and gynecology clinics between January 1, 2016, and December 31, 2016. Any previous or current opioid use was extracted from the electronic medical record medication list.

Randomized controlled trial of belladonna and opiate suppository during intravesical onabotulinum toxin A injection.

Background: Intravesical injection with onabotulinum toxin A injection can be performed in-office under local anesthesia. Rectally administered pain medication presents a potentially feasible and previously uninvestigated adjunct to office-based anesthesia protocols.

Objective: The primary aim of this study was to determine whether adding a belladonna and opiate suppository to standard lidocaine instillation resulted in reduction of bladder injection pain during onabotulinum toxin A injection procedure.

Developing expertise in gynecologic surgery: reflective perspectives of international experts on learning environments and processes.

Research in medical education does not provide a clear understanding of how professional expertise develops among surgeons and what experiential factors contribute to that development. To address this gap, the researchers interviewed 16 international experts in female pelvic medicine and reconstructive surgery to assess their reflective perceptions of what specific opportunities and experiences initiated and supported their development toward expertise in their field. Characteristics and influences explaining the speed and quality of expertise development were sorted into the following themes: the dynamic process of expertise development, internal and personal characteristics, general aptitudes and preparatory skills, role modeling and interpersonal influences, opportunities to learn and practice, and roles and reference points.

Validity: applying current concepts and standards to gynecologic surgery performance assessments.

Validity is critical for meaningful assessment of surgical competency. According to the Standards for Educational and Psychological Testing, validation involves the integration of data from well-defined classifications of evidence. In the authoritative framework, data from all classifications support construct validity claims.

Is de novo stress incontinence after sacrocolpopexy related to anatomical changes and surgical approach?

Introduction And Hypothesis: The objective was to investigate the relationship between new onset postoperative stress urinary incontinence (SUI) after sacrocolpopexy (SCP) and anatomical change/surgical approach.

Methods: We analyzed a retrospective cohort of patients with negative preoperative testing for SUI who underwent SCP from 2005 to 2012. Our primary outcome was new onset postoperative SUI.

Venous thromboembolism in women undergoing pelvic reconstructive surgery with mechanical prophylaxis alone.

Introduction And Hypothesis: The objective of this study was determine the frequency of symptomatic perioperative venous thromboembolism (VTE) and risk factor(s) associated with VTE occurrence in women undergoing elective pelvic reconstructive surgery using only intermittent pneumatic compression (IPC) for VTE prophylaxis.

Methods: A multi-center case-cohort retrospective review was conducted at six clinical sites over a 66-month period. All sites utilize IPC as standard VTE prophylaxis for urogynecological surgery.