The Use of Silicone Vaginal Repair Models as an Adjunct to Mannequins for Simulation Training in Sexual Assault Clinical Learning for Obstetrics and Gynecology Medical Residents.

Within urgent care scenarios in obstetrics and gynecology, there is little educational development surrounding sexual assault simulation scenarios, which reveals a need for increased rehearsal opportunities within medical education. Simulation-based medical education using mannequins, standardized patients, and anatomical silicone models have been suggested as a means to improve such parameters by providing realistic training for residents in the rehearsal of sexual assault scenarios and the application of forensic evidence kits. However, sexual assault training is often only provided to emergency medicine physicians and clinical staff and is not currently a mandatory component of obstetrics and gynecology residency programs across most national academic institutions. This technical report describes the development, implementation, and user-based evaluation of a simulation exercise within a sexual assault clinical learning scenario that uses a silicone vaginal model produced using a three-dimensional (3D) printed mold. The silicone model was covered in artificial blood and attached to an existing mannequin to simulate an examination following a violent sexual assault, which resulted in vaginal lacerations. The clinical room in which the simulation was held reflected that of an operating room in an emergency department, complete with simulation confederates acting as an attending general surgeon, nurse, and anesthesiologist. The obstetrics and gynecology residents acted as the urgent care providers being called into the operating room. The residents were briefed by the general surgeon upon arrival and scrubbed into the surgery. Next, they examined and repaired vaginal lacerations on the silicone model attached to the simulation mannequin. Finally, the residents followed up the clinical simulation with an opportunity to rehearse patient communication and empathy by consoling a standardized patient who acted as the victim of the sexual assault. The purpose of this technical report is to evaluate the efficacy of a silicone vaginal model created from a 3D printed mold, which included a second-degree laceration, to train obstetrics and gynecology residents in the repair of injuries resulting from sexual assault. An evaluation survey was completed by attending residents and the results were strongly in favor of using such anatomical silicone models to increase realism and for the improvement of procedural competency in repairing vaginal lacerations caused by sexual assault.