A Randomized Controlled Trial Assessing the Efficacy of the Fundamentals of Vaginal Surgery Simulation System With Instructional Videos in Medical School Preclinical Education

INTRODUCTION: Foundational operative skills are critical for medical students’ clinical performance and residency readiness, but pre-clinical opportunities for OB/GYN surgical skill development are limited. Simulation and video-based curricula may improve proficiency and confidence but are underexplored in OB/GYN education. This study addresses this gap by evaluating self-directed video practice with the Fundamentals of Vaginal Surgery (FVS) system. OBJECTIVE: To determine whether a Cognitive Task Analysis (CTA)-based instructional video curriculum with the FVS simulation system enhances skill acquisition through self-practice more effectively than standard demonstration videos in preclinical medical students. METHODS: In this randomized controlled trial, 22 preclinical medical students (see Table 1) were assigned to either CTA-based instructional videos (intervention) or standard demonstration videos (control) while practicing independently on a 3D FVS simulation model. All completed pre- and post-tests on six vaginal surgical tasks. On each test day, students practiced independently for 30 minutes using their assigned videos and simulation system. Primary outcomes were the FVS Assessment (maximum score: 600), global rating scale (maximum score: 35), and self-reported confidence (maximum score: 30). Nonparametric results are presented as median interquartile range, IQR, and Wilcoxon signed-rank/Mann–Whitney U tests were used for within- and between-group comparisons. RESULTS: At baseline, groups were similar in confidence and FVS scores, although the control group had higher global rating scale scores. Task completion per participant was minor, with control median rising from 1 IQR: 0–1 to 1 0–4, and intervention from 1 0–1 to 1 0–4; between-group differences were not significant. Both groups significantly improved confidence (control: 16 14–18 to 19 18–20, p = 0.003; intervention: 15 11–18 to 19 17–20, p = 0.003) and global ratings (control: 18 14–24 to 22 19–27, p = 0.003; intervention: 14 10–17 to 20 18–22, p = 0.003). FVS scores increased in both groups but reached significance only for the intervention group (control: 0 0–15 to 5 0–14, p = 0.10; intervention: 0 0–6 to 10 0–54, p = 0.04). Changes did not differ significantly between groups for any outcome. CONCLUSIONS: Self-practice with educational video review and simulation improved performance and confidence in preclinical students, with comparable gains in both intervention and control groups, suggesting that these scalable instructional tools are a valuable adjunct to traditional education. However, task completion rates and overall scores remained modest relative to the maximum possible, highlighting substantial room for improvement. Future studies should examine curricula with extended practice time and assess performance after clinical experience to better determine readiness for residency.Table 1Table 2