Oocyte retrieval simulator: a safe and efficient tool for training

Study question: The aim of this study was to establish the usefulness of an oocyte retrieval simulator (PICKUPSIM, Accurate srl) for training gynaeco- logists in basic oocyte pick-up techniques. Summary answer: The PICKUPSIM proves to be an adequate and safe train- ing tool for oocyte pick-up, for both novice and non-novice gynaecologists. What is known already: Oocyte retrieval is a common surgical procedure in assisted reproduction treatment. Standard practice is currently to perform a rec- ommended number of procedures under supervision, until the trainee reaches proficiency, but this approach is not tailored on the individual nor safe for the patient. On the contrary, simulator-based training may provide a safe and con- trolled environment for learning basic skills. Study design, size, duration: Prospective, single-centre study at Ferrara Uni- versity Hospital including a total of 13 participants (5 “non novices,” account- ing for Group A and 8 “novices” accounting for Group B) who performed two simulation sessions 1 week apart from each other. Participants/materials, setting, methods: The PICKUPSIM is a box simu- lator, equipped with a transvaginal probe, a needle and a foot pedal pump for aspiration of the follicles. The haptic feedback simulates the resistance to pene- tration of the soft tissues traversed by the Ovum Aspiration Needle, in particular the ovarian surface and the ovarian follicle. Scenarios are based on real clinical images and displayed on a wide-view monitor. The participants also completed a questionnaire on the training system. Main results and the role of chance: The non-novices (Group A) aspired a significantly higher number of follicles in the first try, but proved to be generally slower than the novices (Group B). As to the second try, Group A showed better results in terms of time, while keeping constant the average number of aspired follicles. The novices significantly increased the average number of follicles aspired, reaching results comparable to those of Group A and slightly reduced the medium time needed to complete the procedure. Overall, the two groups improved their performances both in terms of time and efficiency. Most of the participants (81.8%) considered the box simulator useful for the training and for improving hand-eye coordination and wanted to use it for training in the future. They also agreed that the feedback from the trainer during the training course was very useful. Accordingly, 72.7% participants wanted to attend an oocyte retrieval training course using the box simulator in the next future. Limitations, reasons for caution: The small sample size limits the power of our study. Wider implications of the findings: The PICKUPSIM allows acquiring basic skills in oocyte pick-up without risk to patients. Simulator-based training should be considered for developing knowledge as an adjunct to more tradi- tional training on real patients.