Every residency program has learners who excel at different paces. Some residents master new procedures quickly, while others need additional time and practice before they feel confident. In the high-pressure world of surgical training, however, it can be difficult for residents to admit when they are struggling, or for educators to provide extra support without risking stigma or embarrassment.

This is where simulation shines. By offering a safe, low-pressure environment, surgical simulation allows residents who need more practice to strengthen their skills, meet milestones, and build confidence without the added stress of falling behind their peers.

The Challenge of Keeping Pace in Residency

Residency is a demanding time. Residents are expected to build knowledge, refine technical skills, and demonstrate competence under the watchful eyes of mentors and peers. In reality, no two residents progress at exactly the same speed. A few extra repetitions might be all that stands between “getting by” and true confidence for a struggling trainee.

Unfortunately, the traditional apprenticeship model doesn’t always allow for this flexibility. Residents who fall behind may feel pressure to “catch up” during live procedures, which can increase anxiety, prolong learning curves, and in some cases even risk patient safety. Worse, the stigma of needing “extra help” can discourage residents from asking for the support they need.

Why Simulation Makes a Difference

Simulation eliminates many of these barriers by providing a supportive practice space away from the operating room.

No risk to patients. Residents can practice complex gynecologic procedures as many times as necessary without compromising patient safety.

Repetition without judgment. Simulation allows for unlimited practice, helping learners move from the cognitive phase of learning to the autonomous phase.

Tactile realism. Simulators, such as the Miya Model by Miyazaki Enterprises, replicate the feel of real tissue. From the “pop” of passing a needle through a ligament to the resistance of dissecting fascia, the feedback residents receive mirrors the operating room experience.

Self-paced learning. Residents can revisit challenging skills in private or small-group settings, reinforcing mastery without fear of slowing down a full class.

By reframing “extra practice” as a natural and expected part of learning, simulation normalizes skill development and helps remove stigma from the process.

Practical Strategies for Educators

Simulation is most effective when it is intentionally integrated into training programs. For educators, this means creating opportunities for struggling residents to succeed without feeling singled out. Here are a few approaches:

Normalize Simulation as a Core Tool

Introduce simulation as a routine part of training for all residents, not just those who are struggling. This way, residents who spend extra time in the lab won’t feel like they’re being singled out.

Focus on Milestone-Based Goals

Instead of comparing residents to one another, align simulation sessions with competency milestones. For example, use the Miya Model to help a resident demonstrate proficiency in vaginal hysterectomy or sling placement before progressing to supervised OR experience.

Encourage Self-Directed Practice

Provide residents with access to simulators outside of scheduled class time. Private practice sessions allow learners to work on weaker skills at their own pace, reducing embarrassment.

Offer Guided Feedback Without Pressure

Feedback should be constructive and specific. Phrases like, “Let’s revisit this step until it feels natural” emphasize growth rather than deficiency. Simulation allows educators to pause, explain, and repeat procedures in a way that the OR rarely permits.

How the Miya Model Supports Struggling Residents

The Miya Model was designed to bridge gaps in gynecological training by providing realistic anatomy and tactile feedback for a wide range of procedures, including:

  • Speculum and pelvic exams
  • Vaginal hysterectomy (with or without BSO)
  • Transobturator and retropubic slings
  • Bilateral sacrospinous ligament suspension
  • Full-thickness vaginal wall dissection

Because it allows residents to clamp, cut, and tie pedicles and feel tissue responses in real time, the Miya Model supports the development of true surgical muscle memory. This hands-on practice ensures that even residents who initially struggle can refine their skills to the same high level of competence as their peers—without the risks and pressures of practicing on live patients.

The Miya App

The Miya App is a companion tool for the 3D Miya Model, offering step-by-step instructional videos for procedures such as vaginal hysterectomy, retropubic slings, and transobturator slings. It also includes assessment questionnaires adapted from the ACOG Simulations Consortium to support skill evaluation and training. Learn more here.

Final Thoughts

Residency will always be challenging, but learning curves shouldn’t be a source of discouragement. With high-fidelity simulators like the Miya Model, struggling residents can catch up, build confidence, and meet milestones in a supportive environment that prioritizes growth over comparison.

At Miyazaki Enterprises, we believe every resident deserves the opportunity to practice until they’re confident, competent, and ready for the operating room. Simulation makes that possible, not just for top performers, but for every future surgeon.

For more information about the Miya Model, contact Miyazaki Enterprises.