NYU Langone’s Obstetrics and Gynecology Simulation Training Program utilizes a competency-based approach to training and assessment through the development of a nationally standardized simulation curriculum. Our dedicated simulation team continuously assesses the needs of in situ simulation for resident training, new faculty onboarding, and continuing medical education for all of our faculty.

Our mission is to provide safe, realistic, and educational opportunities for obstetrics and gynecology residents, faculty, and entire multidisciplinary teams.

Simulation Curriculum

Our residents and staff have access to the simulation curriculum they need to grow and improve as specialists. This curriculum complements our clinical, research, and didactic training and includes the following.

Multidisciplinary Unit-Based Simulation

The Unit-Based Simulation Program for labor and delivery provides residents, faculty, and staff the opportunity to improve their teamwork and clinical skills through simulation in their own clinical environment.

Twice-monthly in situ simulation sessions on labor and delivery take place at NYU Langone’s Tisch Hospital as well as NYC Health + Hospitals/Bellevue. They are led by Sepideh Mehri, MD. At NYU Langone, the training team also includes Jennifer Aquino, MD, associate director of simulation, nursing educators, and members of the anesthesiology team, who have worked together for more than a decade to support simulation training on the inpatient unit. Monthly in situ simulations take place at NYU Langone Hospital—Brooklyn under the leadership of Christina R. Flores, MD.

The program brings simulation into the clinical environment in order to practice obstetric and neonatal emergencies such as shoulder dystocia, maternal hemorrhage, hypertensive crisis, and maternal cardiopulmonary arrest. Using standardized patients and mannequins, obstetrics and gynecology simulation staff create realistic scenarios designed to teach obstetric teams the technical, behavioral, and communication skills necessary for optimal performance when faced with a real-life emergency. These skill sets are the foundation to fostering a culture of safety in obstetrics.

Obstetric Emergency Courses

This four-hour simulated training session was created in collaboration with the NYC Health + Hospitals Simulation Center and is currently offered at Bellevue by Dr. Mehri to train all levels of providers to work together during obstetric emergencies such as maternal hemorrhage, shoulder dystocia, cord prolapse, and hypertensive emergencies.

Simulation Training for Residents

The following training programs are provided to our residents.

Annual Intern Orientation (Intern Boot Camp)

Our annual intern orientation, also known as intern boot camp, consists of five three- to four-hour sessions for two weeks in June before the first year of residency training starts. The orientation focuses on surgical skills and procedures and includes hands-on, clinically oriented simulation incorporating basic didactics at the following stations: obstetric ultrasound, gynecologic ultrasound (led by a task trainer), suturing and knot tying, perineal laceration repair, laparoscopic skills (using box trainers), neonatal circumcision, cervical exams, placement of fetal scalp electrode and intrauterine pressure catheter (labor management), cesarean delivery, long-acting reversible contraception placement, and knowledge of surgical instruments, sutures, and techniques.

Clinical Training Sessions

Simulation is an indispensable educational tool in obstetrics and gynecology residency training. Our program includes a series of three- to four-hour-long sessions occurring eight times throughout the academic year for all residents at the state-of-the-art facility at the New York Simulation Center for the Health Sciences (NYSIM). Throughout the year, residents participate in programs using the SimMom simulator, a variety of pelvic models, models for advanced hysteroscopy, and laparoscopy simulators. Additionally, residents participate in advanced laparoscopic skills training and cadaver lab with laparoscopy capabilities.

Annual Clinical and Surgical Skills in Obstetrics and Gynecology

The Obstetrics and Gynecology Residency simulation curriculum focuses on the following obstetrics and gynecologic topics:

• postpartum hemorrhage
• shoulder dystocia
• hypertensive emergencies and eclampsia
• twin breech delivery
• operative vaginal delivery
• perineal laceration repair
• hysteroscopy and cystoscopy
• basic and advanced laparoscopic skills
• total abdominal, laparoscopic, and vaginal hysterectomies

Robotic-Assisted Laparoscopy

Our five-part course on robotic laparoscopy helps residents become “robot ready,” in compliance with patient safety standards. Residents receive exposure to the large case volume necessary to become skilled in robotic surgery. Unlike traditional surgery and the assistant–apprentice model, robotic surgery requires additional specialized training in the use of complex technology before a surgeon can operate independently. Trainees who complete this pathway are able to sit at the console and operate in major cases.

The course consists of a self-directed didactic component developed by Intuitive, manufacturers of da Vinci robotic surgical systems, which includes an online module and a reading list. Also included are two hands-on operating room dry labs. The first includes docking and undocking the robot and bedside assist skills; the second addresses the console. Each lab is three hours long for a total of six hours.

Training also includes proctored experience with bedside assisting at the patient cart to solidify knowledge of laparoscopic spatial awareness, robotic docking, instrument exchanges, and troubleshooting. Residents also complete a self-directed series of virtual reality simulation modules using the da Vinci robotic trainer. Logging cases and faculty evaluations enable trainees to maintain competency.

Annual Colposcopy and Loop Electrosurgical Excision Procedure

Taking place in July, this session for first-year residents focuses on surgical skills and procedures, names of colposcopy instruments, loop electrosurgical excision procedure, and administration of paracervical block, with hands-on, clinically oriented simulation incorporating basic didactics into each station.

Annual Hysteroscopy Lab

The hysteroscopy simulation lab provides first-year residents with hands-on training combined with didactic sessions covering diagnostic and operative hysteroscope assembly, bipolar resectoscope with fluid management (green pepper model), hysteroscopic morcellators (TruClear, plastic model), and cystoscope assembly and cystoscopy performance.

Annual Laparoscopy Lab

The preceptors for this lab are faculty experienced in laparoscopy. We offer the lab at least four times a year, with one residency class attending each time. Residents receive laparoscopic training to simulate the following procedures: laparoscopic entry into the abdomen, salpingectomy and salpingostomy, cystectomy, opening the pelvic sidewall and potential spaces, radical dissection and ureterolysis, pelvic lymph node dissection, hemorrhage control, and laparoscopic suturing. This lab is hosted by Columbia University Irving Medical Center.

Annual Anatomy Lab

The materials and handouts for this annual session, which was created for all residents, are continually updated to help guide surgical dissection, identify and review all pelvic and abdominal anatomy relevant to gynecologic surgery, and clinically correlate this anatomy with steps of the procedures and surgical complications. The simulation takes residents through pelvic dissection with an emphasis on core procedures, with instruction from gynecologic oncology and female pelvic medicine and reconstructive surgery faculty and fellows. The goal of the session is for residents to observe the pertinent anatomy and perform radical gynecologic and advanced pelvic surgical procedures in a low-risk setting.

Biannual Dry Lab Session for Basic and Advanced Laparoscopy Skills

The dry lab session, which is offered twice a year, is primarily for third-year residents and covers basic and advanced open and laparoscopic skills adapted from the Society of American Gastrointestinal and Endoscopic Surgeons’ Fundamentals of Laparoscopic Surgery (FLS) curriculum for gynecologic surgery. The course includes skills in hand–eye coordination, laparoscopic cystectomy, and laparoscopic suturing and knot tying. The course is facilitated by the Surgical Skills Laboratory, part of the Department of Surgery at NYU Grossman School of Medicine, under the guidance of Peggy Gluszak, RN, who is also an FLS trainer.

Simulation Training for Medical Students

Integrating simulation training with third-year clerkship orientation ensures that all students get uniform instruction and experience at the beginning of their obstetrics and gynecology rotation. Students spend an afternoon in the simulation lab after didactic lectures in small groups. They also visit a series of stations hosted by faculty members who guide them through skills sessions including suturing, knot, and vaginal delivery. This hands-on experience on day one of their rotation not only provides practical knowledge as they prepare to enter their obstetrics and gynecology clerkship but also helps the students with increasing confidence and improving their performance.

Simulation Training Program Faculty

Sepideh Mehri, MD
Director of Simulation in Obstetrics, NYU Langone
Director of Simulation in Obstetrics, and Gynecology, Bellevue

Jennifer Aquino, MD
Co-Director of Simulation in Obstetrics, NYU Langone

Christina M. Escobar, MD
Director of Simulation in Gynecology, NYU Langone

Christina R. Flores, MD
Director of Simulation, NYU Langone Hospital—Brooklyn

Jessica S. Rose, MD
Associate Residency Director, Bellevue

Olivia Lu, MD
Associate Residency Director, NYU Langone Hospital—Brooklyn

Olivia P. Myrick, MD
Residency Director, NYU Langone

Alexandra Dryer, MD
Associate Reidency Director, NYU Langone, Tisch