Hypothesis / aims of study
Pelvic floor muscle (PFM) dysfunction significantly impacts individuals across all genders, contributing to conditions such as stress urinary incontinence (SUI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (1). Effective evaluation of PFM strength and tone is crucial for diagnosis and management (2). The SimLevator™ (Picture 1), a novel high-fidelity dynamic simulator, has been developed to provide a standardised, reproducible, and ethical training solution for healthcare professionals working in pelvic health. This pilot study sought to evaluate the effectiveness, reliability, and usability of the SimLevator® as an educational tool for training in PFM assessment. Specifically, the pilot explored trainees’ perspectives on confidence-building, learning outcomes, and accuracy to clinical presentations.
Study design, materials and methods
A mixed-methods pilot study took place at a Higher Education Institution in London, involving structured training sessions with the SimLevator® including 10 trainees and 2 expert professionals (physiotherapist and nurse). Quantitative data collection included the trainees’ observation of the device performance (e.g., muscle tone detection readings, muscle contraction detection) and trainee’s confidence levels. Qualitative data captured the trainees’ experience through a qualitative interview after the use of the simulator. The pilot study was introduced in a scheduled teaching session, and trainees were given the option to opt out from the evaluation of the simulator. Confidence in completing PFM assessment was measured at the beginning of each trainee session.
Results
The majority of participants (n=8) demonstrated consistency between the ability to detect the status of the simulator (tone and muscle movement) with their level of experience and self-reported confidence. Qualitative findings highlighted the device’s advantages, including standardisation, reduced ethical concerns, and an improved learning environment for interprofessional training. However, some trainees noted limitations, such as a lack of anatomical variability in the SimLevator® and lack of resistance response to digital palpation.
Key themes emerging from qualitative data included:
1. Comparison with peer-based learning: The SimLevator® appears less intimidating and more accessible; however, it lacked the human tissue variability inherent in peer assessments.
2. Comparison with still models: The device proved superior to static models due to its capacity for replicating contractile function, although participants indicated a need for improved anatomical detail.
Interpretation of results
The SimLevator® presents a promising advancement in PFM assessment training, offering a repeatable, ethical, and dynamic learning tool that enhances trainee’s confidence and skill acquisition. While the device serves as a valuable precursor to clinical practice, further refinements, including enhanced anatomical accuracy, resistance pressure feedback, and pathology variations, are recommended to improve realism and clinical applicability. Future research and development will focus on evaluating the validity and test-retest reliability of the SimLevator® device when used by expert pelvic health practitioners and integrating the device into broader curricula and evaluating its long-term impact on clinical competency.