USING PRACTICAL AND DYNAMIC MODELS TO TEACH AND PRACTICE PELVIC ORGAN PROLAPSE QUANTIFICATION (POP-Q) EXAM TO RESIDENTS OF GYNECOLOGY
B. LIRAZAN, J. AGUINALDO, L. T. PRODIGALIDAD;
Univ. of The Philippines - Philippine Gen. Hosp., Manila, Philippines.
Introduction: Pelvic organ prolapse, although a common problem especially among the elderly, is often crudely diagnosed and characterized between practitioners due to the possible lack in accepted system in grading. In 1996, a paper by the International Continence Society (ICS) was published to standardize the terminology of pelvic organ prolapse called Pelvic Organ Prolapse Quantification System (POP-Q) (1). Although already an international standard in the evaluation of pelvic organ prolapse, it is perceived to be difficult to learn by most. (2)
Objective: This study aims to use a practical and dynamic model and make a simple and intuitive way to teach and practice POP-Q scoring.
Methods: This is a prospective observational study involving volunteer Gynecology residents in a tertiary referral center for the year 2016. The participants underwent a 15-minute lecture given by a consultant of Urogynecology introducing concepts, clinical relevance, detailed explanation of staging and of every point measured in POP-Q system. It was followed by a hands-on workshop using a dynamic tool made from a marked sock placed in a cardboard tube. A 10-point questionnaire given before and after the activity was used to measure objective change in the understanding and knowledge on POP-Q system. A self assessment questionnaire involving a 5-point Likert scale was also used to determine subjective change in understanding, perceived difficulty and comfort in performing POP-Q to actual patients.
Results: A total of 28 residents of Gynecology in all year levels participated in the study. Across all year levels, a statistically significant increase from a mean baseline score of 5.36 ± 2.04 to a post-session score of 9.07 ± 1.30 was noted from the 10-point questionnaire. Using the self-assessment questionnaire, 27 participants (96.4%) reported statistically significant increase of scores in their knowledge, perceived difficulty, comfort performing, and confidence in teaching the POP-Q system by answering only “agree” or “strongly agree” in the 5-Point Likert scale after the activity. Twenty six (93%) participants also rated for the teaching model to be a “very good” and “excellent” learning aid in learning POP-Q.
Conclusions: This study has shown that the use of a teaching model made from a marked sock supported by cardboard tubing is an effective, affordable and feasible option to teach and practice POP-Q system to residents of gynecology. It was found to increase knowledge and understanding of basic concepts on POP-Q and improve confidence on performing POP-Q on actual patients.
References: 1. AJOG, 1996; 175(1):10-7.
2. IUJ. 2000; 11:48-60.
Figure 1. Picture of the teaching model and a popsticle stick