A Novel Approach to Diagnostic and Operative Hysteroscopy Training: Hands-On Training With One-to-One Tutoring in Live Patients.

INTRODUCTION

Hysteroscopy is the gold standard technique for the evaluation and treatment of intrauterine pathology related to infertility, abnormal bleeding, and recurrent miscarriages. Hysteroscopy training is a fundamental part of training in gynecology. We report an innovative live-patient hysteroscopy training curriculum developed by the Second Department of Obstetrics and Gynecology of ''Aretaieion'' University Hospital of Athens, Greece.

METHODS

The program includes a two-day course integrating both theory and hands-on sessions. The theoretical component encompasses pelvic anatomy, instrument-related physics, recognition of uterine pathology, indications of hysteroscopy, patient preparation, use of ultrasound, management of complications, and post-surgery care, promoting a deeper comprehension of limitations and applications of hysteroscopy. On the first day of practical training, trainees use hysteroscopic instruments in small groups in a dry lab under the supervision of experienced tutors. On the second day, they move on to live-patient cases for diagnostic and surgical hysteroscopy. Participants are exposed to a wide spectrum of surgical interventions ranging from simple diagnostic hysteroscopy to more advanced procedures such as International Federation of Gynecology and Obstetrics (FIGO) type 2 myomectomy or intrauterine adhesion management.

RESULTS

Post-course evaluation via a questionnaire has served as a valuable aid in the continuous improvement of the training program, in line with the ever-evolving field of hysteroscopic surgery. The overall satisfaction of the participants according to the self-reported 5-point verbal numeric rating scale (VNRS-5) was very high (mean score 4.8).

CONCLUSION

Our program addresses the lack of sufficient hysteroscopy training and offers an alternative to simulation-based training. Its curriculum is pioneering, combining theoretical as well as hands-on training with one-to-one tutoring in live patients, facilitating gynecologists to incorporate hysteroscopic procedures with more confidence into their surgical practice.