REVIEW article
Front. Med.
Sec. Obstetrics and Gynecology
Effectiveness and implementation of simulation training in obstetric and gynecological surgery education: Systematic review and meta-analysis
Provisionally accepted
- 1Zhejiang University, Hangzhou, China
- 2Zhejiang Key Laboratory of Precise Protection and Promotion of Fertility, Hangzhou, China
- 3Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
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This systematic review and meta-analysis evaluated the effectiveness and implementation of simulation-based training in obstetrics and gynecology surgical education. Following PRISMA 2020 guidelines, multiple databases were searched through December 2024, ultimately including 30 randomized controlled trials involving 1,247 participants. Random-effects meta-analysis was conducted to assess technical skills, operative time, learner confidence, and patient outcomes. The analysis revealed that simulation training significantly improved surgical skill scores compared to traditional teaching (SMD=0.82, 95%CI: 0.64-1.00, P<0.001), reduced operative time (SMD=-0.62, 95%CI: -0.81 to -0.43, P<0.001), and enhanced learner confidence (SMD=0.71, 95%CI: 0.49-0.93, P<0.001). Both high-fidelity virtual reality simulators and low-fidelity box trainers demonstrated comparable effectiveness in skill enhancement (P=0.28). Proficiency-based training exhibited lower heterogeneity (I2=32.4%) compared to fixed-repetition training (I2=58.7%). However, patient-related outcomes were severely underreported, with only 3 studies (10.0%) documenting complications or blood loss. Implementation analysis identified high equipment costs, lack of protected training time, and insufficient faculty expertise as primary barriers. This study provides robust evidence supporting simulation training integration into residency curricula while highlighting critical gaps in patient outcome assessment and implementation research requiring future investigation.
Keywords: implementation, Meta-analysis, Obstetrics and Gynecology, Simulation training, surgical education
Received: 27 Oct 2025; Accepted: 03 Dec 2025.
Copyright: © 2025 Li, Li and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cuiyu Yang
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