Embryo transfer simulation improves pregnancy rates and decreases time to proficiency in Reproductive Endocrinology and Infertility fellow embryo transfers

Objective To design and evaluate an ET simulator to train Reproductive Endocrinology and Infertility (REI) fellows’ techniques of ET. Design Simulation model development and retrospective cohort analysis. Setting Not applicable. Patient(s) Patients undergoing IVF. Intervention(s) Simulation model ev...

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Bibliographic Details
Published in:Fertility and sterility 2017-05, Vol.107 (5), p.1166-1172.e1
Main Authors: Heitmann, Ryan J., D.O, Hill, Micah J., D.O, Csokmay, John M., M.D, Pilgrim, Justin, D.O, DeCherney, Alan H., M.D, Deering, Shad, M.D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Clinical Competence - statistics & numerical data
Educational Measurement - statistics & numerical data
Embryo transfer
Embryo Transfer - methods
Embryo Transfer - statistics & numerical data
Endocrinology - education
fellowship education
Female
High Fidelity Simulation Training - methods
High Fidelity Simulation Training - statistics & numerical data
Humans
Infertility, Female - epidemiology
Infertility, Female - therapy
Internal Medicine
medical simulation training
model development
Obstetrics and Gynecology
Pregnancy
Pregnancy Rate
pregnancy rates
Reproductive Medicine - education
Treatment Outcome
Young Adult
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Summary:Objective To design and evaluate an ET simulator to train Reproductive Endocrinology and Infertility (REI) fellows’ techniques of ET. Design Simulation model development and retrospective cohort analysis. Setting Not applicable. Patient(s) Patients undergoing IVF. Intervention(s) Simulation model evaluation and implementation of ET simulation training. Main Outcome Measure(s) Pregnancy rates. Result(s) The REI fellow and faculty evaluation responses (n = 19/21 [90%]) of the model demonstrated realistic characteristics, with evaluators concluding the model was suitable for training in almost all evaluated areas. A total of 12 REI fellows who performed ET were analyzed: 6 before ET trainer and 6 after ET trainer. Pregnancy rates were 31% in the initial 10 ETs per fellow before simulator vs. 46% after simulator. One of six pre–ET trainer fellows (17%) had pregnancy rates ≥40% in their first 10 ETs; whereas four of six post–ET trainer fellows had pregnancy rates ≥40% in their first 10 ETs. The average number of ETs to obtain >40% pregnancy efficiency was 27 ETs before trainer vs. 15 ETs after trainer. Pregnancy rates were similar in the two groups after 20 ETs, and collective terminal pregnancy rates were >50% after 40 ETs. Conclusion(s) Embryo transfer simulation improved REI fellow pregnancy rates in their first 10 transfers and led to a more rapid ET proficiency. These data suggest potential value in adopting ET simulation, even in programs with a robust history of live ET in fellowship training.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2017.01.016