Publication:

Impact of multidisciplinary team simulation-based training of residents to improve the outcome of operative vaginal deliveries and obstetric emergencies

Background Obstetric emergencies such as eclampsia, atonic postpartum hemorrhage and maternal collapse, use of vacuum or forceps for operative vaginal deliveries are high pressure situations where residents don’t feel very confident due to lack of practice. Use of high-fidelity simulation to improve the skill-set and confidence level was the main objective of this study.

Methods This study was done in the D. Y. Patil University simulation lab over a period of 1 month. 42 postgraduate junior residents of the Department of Obstetrics and Gynaecology were included in the study. A pre and post workshop questionnaire on the subject and a confidence questionnaire were used to assess the residents. Three case-based scenarios were constructed on the high-fidelity simulator for the residents in the workshop followed by a debriefing of each case.

Results The improvement in the knowledge and confidence for managing postpartum hemorrhage and eclampsia was from a mean value of 3.5±1.0 (2-6) and 4.7±1.0 (3-6) respectively in the pretest and a mean value of 8.2±0.8 (7-9) and 8.5±1.1 (6-10) respectively in the post test. The response time to postpartum hemorrhage and setup of eclampsia kit also had statistically significant p value of less than 0.0001.

Conclusions Practice of obstetric emergencies, improving team building, communication and techniques of operative vaginal deliveries are all within the confines of a simulation laboratory. They are helpful in improving the proficiency of the junior residents and would eventually improve maternal and fetal outcomes.