Development of a dilation and evacuation technical skills model
Awarded 2012
Complex Family Planning Fellowship Research
Jennefer Russo, MD
University of Pittsburgh

Background: Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester dilation and evacuation training.
Objective: We report physicians’ assessments of the realism of 3 dilation and evacuation models to establish a composite training model.
Methods: We surveyed experienced providers at 2 national conferences to evaluate 3 dilation and evacuation models and rate each model’s components on a Likert scale.
Results: Fifty-five obstetrics-gynecology and family medicine physicians completed the survey. Most respondents rated 4 components of 1 model as somewhat realistic or very realistic. The components rated highest were the fetal parts (82% [45 of 55]) and placenta (60% [30 of 50]). This model was rated as more likely to be used in training by 80% (43 of 54) of participants than the 2 other models, as rated by 28% (15 of 54) and 9% (5 of 54) of participants.
Conclusions: A model made from a plastic bottle containing a stuffed fabric form with detachable parts has tactile similarity to a dilation and evacuation procedure and should be further developed for testing and training.

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