Development of a Novel, Low-Cost, Low-Fidelity Simulation Model for Pudendal Nerve Block Application

Abstract

Background Pudendal nerve block is an important alternative to neuraxial anesthesia, yet studies demonstrate that 3% to 50% of pudendal nerve blocks are ineffective. Lack of clinician training is the most common cause, and there are no simulation models currently described. Objective To develop and test a novel, low-cost, low-fidelity simulation model for training residents in the placement of a pudendal nerve block. Methods A pudendal nerve block model was developed using commonly found supplies, with a cost of $20.57. First-year to fourth-year obstetrics and gynecology (OB/GYN) and family medicine (FM) residents were invited to 1 of 4 pudendal nerve block 1-hour simulation sessions from December 2019 to March 2021 during their required teaching sessions. Expert faculty led a discussion of pudendal nerve blocks, then participants practiced with the described model. A survey about the model was created by the authors and administrated prior to and immediately after the session. Pre-and post-surveys were analyzed by Wilcoxon signed rank tests, and Bonferroni correction was performed. Results Thirty-four out of a total of 36 eligible residents participated (94%). Residents showed improvement in knowledge (median pre-simulation score 43.99 compared with 70.06 post-simulation, P