Leslie Kammire, MD

Associate Residency Director: Surgical Curriculum
Obstetrics and Gynecology
Wake Forest School of Medicine

The past 10 years have witnessed the beginnings of the simulation for surgical training and we are still in the development stage of this movement. We need better models for surgical training that are realistic and not overly expensive. For this reason, I am very excited about the Miya Model. It is the first model developed for teaching the steps of a vaginal hysterectomy as well as other vaginal reparative procedures. I have practiced with this model and it is realistic with regards to size, shape, and feel of tissue. Residents will be able to perform a vaginal hysterectomy or vaginal repair from start to finish on the model, while we the teachers are able to observe from the top of the model. This observation from above is an advantage the model has over live surgery: I will be able to ascertain correct clamp placement better than watching from the side or looking over their shoulder, as I currently do in the operating room when they are working on a real patient. I will also be able to give them pointers about how to angle their needle correctly, which I currently struggle with as I am watching from the side. The ACGME (American College of Graduate Medical Education) has recently created new standards, called Milestones, for residents in all specialties to demonstrate competence in procedures, including both office based and surgical procedures. Previously residents have been signed off as being competent to practice their specialty after completing a set number of years of training, but have not been required necessarily to demonstrate competency in the performance of specific procedures.

These competencies are an effort to assure that training is more standardized across programs, so that, for example, when a resident completes 4 years of an accredited Ob-Gyn residency, they will have demonstrated ability to perform necessary procedures for our specialty no matter where they trained. In our specialty these Milestones are in the process of development; we are currently working on the first year. These initial Milestones include simple office based procedures such as endometrial biopsies and dilation of the cervix, cervical biopsy, etc. The Miya Model will have adaptations that will allow it to be used for demonstration of competency for both these simple Milestones as well as more advanced surgical procedures, giving it more versatility than current models that only have 1 or 2 applications. Our program is planning to purchase a Miya Model once production is started, and we are looking forward to using it for our residents at all levels of training.

Matthew Coe

One World DMG | PharmaDesign, Inc.

As a designer and manufacturer of medical simulation models, we receive frequent inquiries from the market requesting multi-functional surgical trainers with advanced capabilities. Unfortunately, medical device and supply companies have been unable to follow through with the detailed and time-consuming development process that such invention requires. This seems to be due to a lack of human resources, direction, and various other inter-corporate restrictions. Dr. Miyazaki possesses both the expertise and commitment to satisfy this obvious need, as shown through both Doug’s research and our own repeated experience.

This training model promises to provide the gynecological community with a long desired combination of interchangeable pathologies, real bleeding vessels, replaceable tissues for practicing dissection, suture, etc., etc. We strongly believe that this unprecedented surgical trainer will have an impact on education and innovation in the field for many years to come.