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Simulation-based training for embryo transfer for clinicians with differing levels of expertise: An application of the ASRM Embryo Transfer Simulator

  • Author Footnotes
    ∗ These authors should be considered as joint first authors
    Katherine M. Baker
    Correspondence
    Corresponding author: , Telephone: 954-593-1481, Address: Department of OB/GYN, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Kirstein 3, Boston, Massachusetts, 02215
    Footnotes
    ∗ These authors should be considered as joint first authors
    Affiliations
    Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    Harvard Medical School, Boston, Massachusetts, USA
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  • Author Footnotes
    ∗ These authors should be considered as joint first authors
    Angela Q. Leung
    Footnotes
    ∗ These authors should be considered as joint first authors
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    Boston IVF, 130 2nd Avenue, Waltham, Massachusetts, 02451, USA

    Harvard Medical School, Boston, Massachusetts, USA
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  • Jaimin S. Shah
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    Boston IVF, 130 2nd Avenue, Waltham, Massachusetts, 02451, USA

    Harvard Medical School, Boston, Massachusetts, USA
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  • Ann Korkidakis
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    Boston IVF, 130 2nd Avenue, Waltham, Massachusetts, 02451, USA

    Harvard Medical School, Boston, Massachusetts, USA
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  • Denny Sakkas
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham, Massachusetts, 02451, USA
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  • Alan Penzias
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    Boston IVF, 130 2nd Avenue, Waltham, Massachusetts, 02451, USA

    Harvard Medical School, Boston, Massachusetts, USA
    Search for articles by this author
  • Thomas L. Toth
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    Boston IVF, 130 2nd Avenue, Waltham, Massachusetts, 02451, USA

    Harvard Medical School, Boston, Massachusetts, USA
    Search for articles by this author
  • Author Footnotes
    ∗ These authors should be considered as joint first authors
Open AccessPublished:August 12, 2022DOI:https://doi.org/10.1016/j.xfre.2022.08.003
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      ABSTRACT

      Objective

      To compare the learning curve of clinicians with different levels of embryo transfer (ET) experience using the ASRM Embryo Transfer Simulator.

      Design

      Prospective cohort study

      Setting

      Single large university-affiliated IVF Center

      Patient(s)

      Participants with three levels of expertise with ET were recruited: “Group 1” (REI attendings), “Group 2” (REI nurses, advance practice providers, or medical assistants), and “Group 3” (OB/GYN resident physicians).

      Intervention(s)

      All participants completed ET simulation training using uterine cases A, B, and C (easiest to most difficult) of the ASRM ET Simulator. Participants completed each case 5 times for a total of 15 repetitions.

      Main Outcome Measure(s)

      The primary outcome was ET simulation scores analyzed at each attempt for each uterine case, with a maximum score of 155. Secondary outcomes included self-assessed comfort levels before and after the completion of the simulation and total duration of ET. Comfort was assessed using a 5-point Likert scale.

      Result(s)

      Twenty-seven participants with three different levels of expertise with ET were recruited from December 2020 to February 2021. For Cases A and B, median total scores were not significantly different between Groups 1 and 3 at first or last attempts. Group 2 did not perform as well as Group 3 at the beginning of Case A (p=0.01) or Group 1 at the end of Case B (p=0.008). All groups demonstrated a decrease in total time from first attempt to last attempt for both cases. For Case C, the “difficult” uterus, Groups 2 and 3 exhibited the greatest improvement in total median score: from 0 to 75 from first to last attempt. Group 1 scored equally well from first through last attempts. While no one from Group 2 or 3 achieved a passing score with first attempt (80% of the max score), approximately 30% had passing scores at last attempt. Group 1 and 3 showed a significant decrease in total time across attempts for Case C. Following simulation, 100% of Groups 2 and 3 reported perceived improvement in their skills. Group 3 showed significant improvement in comfort scores with Likert scores of 1.71 ± 0.76 and 1.0 ± 0.0 for the “Easy” and “Difficult” cases, respectively, prior to simulation and 4.57 ± 0.53 and 2.4 ± 1.1 following simulation (p=0.01, 0.015).

      Conclusion(s)

      The ASRM ET Simulator was effective in improving both technical skill and comfort level, particularly for those with little to no ET experience and was most marked when training on a difficult clinical case.

      Keywords