Neonatal Circumcision Simulation: A Resource for Beginners.

Abstract

Introduction: Neonatal circumcision is one of the most common procedures performed on males in the United States. Though not a required procedure to learn during residency, an interest in learning this skill exists. Simulation provides an opportunity to be exposed to, and gradually master, procedural skills. We report our experience developing a circumcision simulation session, among a large pediatric intern class.

Methods: Participants received an instructional video for asynchronous viewing in advance of an in-person small-group session. Stations for six participants and two facilitators were equipped with Gomco clamp kits and a 15-step checklist. Facilitators demonstrated the neonatal circumcision procedure as participants followed along step-by-step. Bidirectional, real-time feedback was provided. Upon completion, an optional survey allowed participants to anonymously evaluate the course. Descriptive statistics were used for analysis.

Results: Fifty-three interns participated, with a 72% survey completion rate. The simulation session received an overall average rating of 4.9 (based on 5-point Likert scale; 1 = terrible, 5 = excellent). On several questions (yes/no response options), respondents unanimously reported that the session allowed identification of areas for targeted improvement, was helpful to experience prior to performing a circumcision on a newborn patient, and improved confidence.

Discussion: The 30-minute neonatal circumcision simulation session was well-received, exposed learners to a desirable procedure, allowed identification of targeted areas for improvement, and increased confidence. Strengths of our session include novel application of a 3D-printed model and a flexible framework that can be adapted to suit a variety of settings, learners, and available resources.