Background: Although mandated by the ACGME, access to comprehensive abortion training is severely limited, and recent legislative restrictions have further decimated educational opportunities for learners. In states with limited to no abortion access, resident physicians must travel to external programs to gain this necessary training. Simulation-based training has been shown to increase clinical proficiency and improve patient care outcomes. There is a critical need for pre-clinical, comprehensive, simulation-based training to prepare resident physicians for abortion care clinical experiences.

Methods: Using an iterative design process, we created an innovative, affordable, and modifiable pelvic training model with an associated clinical curriculum under the guidance of two board-certified obstetrics and gynecology (OB/GYN) physicians. The ReproSTART model and curriculum is designed to teach five key surgical techniques necessary for procedural abortion and is modifiable for various clinical situations. OB/GYN physicians and trainees tested each procedural station and component of the model to provide qualitative feedback. Thirty-one resident physicians representing all years of training completed three varying workshops and provided feedback via pre- and post-session evaluations. A website was created to disseminate the ReproSTART model and curriculum to other institutions (https://obgyn.mcw.edu/repro-start/ password:abortion).

Results: Abortion care experts and resident trainees found the ReproSTART model and associated curriculum to be superior to currently available models and hands-on trainings for abortion procedural techniques. Learners across all levels of training found the simulation to be useful for developing familiarity with procedural techniques, and first-year resident physicians showed a significant improvement in reported confidence with the abortion-related procedural techniques after completing the training. Furthermore, Ob/Gyn Residency Programs have reported success in building the model and implementing the training using only the website as a guide.

Conclusion: The novel ReproSTART model and curriculum is an innovative simulation-based training to familiarize resident physicians with abortion procedural techniques. The model provides a more accurate, dynamic, and comprehensive pelvic anatomy than previous models, and the simulation allows for increased familiarity with procedural techniques and improved confidence in early learners. The ReproSTART model, curriculum, and website allows for more equitable and accessible abortion procedural training. The simplicity and adaptability of the ReproSTART model provides potential additional wide-reaching benefits for simulation-based training in obstetrics and gynecology.