Improving the confidence level and surgical skills of undergraduate medical students by using pig-perineum simulation-based learning

Background In many developing countries facing medical personnel shortage, including Thailand, medical graduates are required to have enough confidence and competence to perform essential procedures by themselves. They should be competent in episiotomy and perineal repair. In the early phase of actual practice of episiotomy on real patients, new clinical students are usually unskilled and less confident. To improve medical students' competency and confidence in performing basic procedures, we developed a pig-perineum simulation-based learning program. The aim of this study is to evaluate the confidence levels of medical students as well as their perspectives regarding the effectiveness of pig-perineum simulation-based learning. Methods Medical students participated in a pig-perineum repair workshop on identifying perineal laceration, knot-tying, and perineal laceration repair, under the instruction of skilled staff members. The workshop was meant to achieve transfer of skills from the simulated setting of our course to the actual practice on patients in the labor ward and the maternity operating room. All the participants were instructed to answer the questions on a questionnaire after the simulation. The confidence, skills, satisfaction, and learning achieved through the simulator were assessed using a 5-point Likert scale, based on the systematically validated questionnaire. Results Seven hundred and ninety-two medical students were enrolled in the study. The mean self-efficacy scores before and after the simulation were 3.63 and 4.16 respectively (paired t-test, p-value < 0.001). The mean satisfaction score was high (4.22), inspiring them to enhance their surgical skills in knot-tying and perineal laceration repair. The mean self-evaluation score of the participants regarding their perspectives on the closeness to reality of pig-perineum repair when compared to real clinical practice was high (4.09), making them more confident in practice in the labor room. Conclusion Pig-perineum simulation-based learning improves confidence level and surgical skills in undergraduate medical students. This approach appears to enhance competency during clinical practice.