Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

Table 4

Questionnaire.

	Affiliation (mark with a cross)
1	Year of residence	R3		R4
2	Hospital	Level II		Level III
3	Number of births/year (2006)
4	Number of residents/year
5	Gender	Male		Female
	Evaluation on the knowledge of anatomy (mark with a cross)
6	Do you think you have adequate knowledge of the pelvic floor anatomy?	YES		NO
7	Do you know the name of the various muscles of the pelvic floor?	YES		NO
8	Are you able to recognize the various muscles of the pelvic floor during digital vaginal examination?	YES		NO
9	Are you able to identify the tendinous arc of the anus levator during digital vaginal examination?	YES		NO
10	Can you identify the sciatica spines during digital vaginal examination?	YES		NO
11	Do you know the path of the pudenda nerve, and are you able to inject the anaesthetics in it?	YES		NO
	Evaluation on the knowledge of episiotomy (mark with a cross)
12	Do you know when an episiotomy would be indicated?	YES		NO
13	Are you familiar with the suture of the various types of episiotomy (medial, medial lateral)?	YES		NO
14	Do you know when the medial episiotomy is counter indicated?	YES		NO
15	Does your centre apply a selective policy for episiotomy?	YES		NO
16	Do you think a selective policy for episiotomy is positive?	YES		NO
	Evaluation on the knowledge of the perineal tears (mark with a cross or rate from 0 to 5)
17	Do you know the definition of grades III and IV perineal tears?	YES		NO
	Classification of perineal tears grade I: affects the vaginal mucosa and the connective tissue; grade II: affects the underlying muscles in addition; grade III: anal sphincter rupture; grade IV: affects the rectal mucosa
18	Do you feel able to carry out a C-section? (rate from 0 to 5)
19	Do you feel able to repair a grade III or IV perineal tear? (rate from 0 to 5)
20	How many grade III or IV perineal tears have you repaired?	0–10	10–20		>20
21	Can you distinguish between a grade III and a grade IV perineal tear during the usual practice?	YES		NO
22	Do you know more than one technique to repair an anal sphincter injury?	YES		NO
23	Do you know when prophylactic antibiotics should be administered after a tear?	YES		NO
	Evaluation on teaching (mark with a cross)
24	Do you feel competent when repairing a perineal tear?	YES		NO
25	Do you usually followup on a puerpera who has suffered a grade III or IV perineal tear after discharge (followup, pain level, sexual and anal dysfunctions)?	YES		NO
26	Do you know if there is any difference in the risk of urinary and faecal incontinence after birth (due to mechanical lesion) depending on whether the birth is spontaneous or instrumental?	YES		NO
27	Do you know if any of the instruments (spatules, forceps, vacuum pads) have higher associated risk or are their risks equivalent?	YES		NO
28	Did you have a teaching assistant help during your suture in your first perineal tear repair?	YES		NO
29	Did an assistant supervise/help you on subsequent occasions?	YES		NO
30	Or did a major resident, in the absence of assistants?	YES		NO
31	Do you think that you received adequate supervision when faced with a grade III or IV perineal tear?	YES		NO
32	Do you think you can teach a minor resident to repair a grade III or IV perineal tear, in practice?	YES		NO
33	Have you received formal training on pelvic anatomy or on the repair f perineal lacerations, within your training programme?	YES		NO
34	Have you received theoretical training in any clinical session, videos, articles offered by any assistant?	YES		NO
35	Have you read books, articles related to pelvic anatomy, perineal tears, episiotomy, surgical techniques for repairs, and so forth?	YES		NO
36	Have you received any theoretical-practical training with corpses?	YES		NO
37	Do you think you need to receive more supervision by an assistant or major resident to repair grade III or IV perineal tears?	YES		NO
38	Do you think you need more theoretical training on it?	YES		NO
39	Do you think a theoretical-practical course on the anatomy of he pelvic floor and the repair of its lesions would be useful?	YES		NO
40	Would you give the same replies if you reread the questions after some minutes?	YES		NO