A Comparison of the Bouquet Speculum and Traditional Two-Blade Speculum in Medical Student Training for Female Gynecological Exams

Cassandra Brown,1 Shivani Dixit,1,2 Jennifer Gaide1,2 1College of Osteopathic Medicine, Rocky Vista University, Englewood, CO, USA; 2Office of Simulation in Medicine and Surgery, Rocky Vista University, Englewood, CO, USACorrespondence: Cassandra Brown, Rocky Vista University, 8401 S Chambers Road, Englewood, CO, 80112, USA, Email [email protected]: The objective of this study was to compare the Bouquet Speculum™ to a traditional two-blade speculum on a complex-anatomy vaginal task among preclinical medical students. The novel task trainer was designed and created to simulate obese anatomy for the complicated speculum exam. This study was conducted at Rocky Vista University College of Osteopathic Medicine in Parker, Colorado.Methods: A novel vaginal model simulating anatomy that is prone to lateral wall collapse was used to compare the speed and preference of a traditional two-blade vaginal speculum to the Bouquet speculum™ among first and second-year medical students (n=47) in a randomized crossover study. Students performed an endometrial biopsy, and quantitative and qualitative measures were recorded including time, speculum preference, difficulty, and confidence.Results: Students successfully placed the endometrial biopsy pipelle faster using the Bouquet speculum™ compared to the traditional two-blade speculum (p < 0.0001). Students self-reported confidence level was significantly associated with faster times, regardless of the speculum used (p=0.0043).Conclusion: The Bouquet Speculum™ significantly reduces the time to completion of an endometrial biopsy performed on a novel vaginal model simulating obese anatomy compared to the traditional two-blade speculum.Keywords: medical education, simulation, speculum, gynecology