Published online May 10, 2014. doi: 10.5317/wjog.v3.i2.85
Revised: February 17, 2014
Accepted: April 11, 2014
Published online: May 10, 2014
Processing time: 175 Days and 2.4 Hours
AIM: To investigate the use of the Gaumard’s Noelle S550.100 Maternal and Neonatal Simulators for teaching forceps delivery.
METHODS: Twenty two (n = 22) resident physicians were enrolled in a simulation course on operative forceps deliveries. The physicians enrolled in the course were all part of an accredited Obstetrics and Gynecology residency program and ranged in their training from post graduate year (PGY) 1-4. Each participant received simulation based teaching on the indications, contraindications, proper application, delivery and removal of forceps by a single teacher. The Gaumard’s simulator and Simpson forceps were used for this course. Statistical analysis using SPSS statistical software was performed after the completion of the simulation training program. A paired student t-test was performed to compare the cohort’s mean pretest and post simulation training scores. Follow up skills assessment scores at one month, 3 mo and 6 mo were compared to the baseline pretest score using a paired student t-test.
RESULTS: There was statistically significant improvement in the post simulation training performance evaluations compared to the pretest, 13.7 (SD = 3.14) vs 7.9 (SD = 4.92), P < 0.05. Scores at 1 mo, 3 mo, and 6 mo were compared to the pretest score and showed retention of skills: 4.6 (SD = 5.5, 95%CI: 2.21-7.07), 4.4 (SD = 5.2, 95%CI: 2.13-6.70), and 5.6 (SD = 4.8, 95%CI: 3.53-7.75) points, respectively. There were statistically significant differences between residents by post graduate training year on pretest scores, however these differences were not present after simulation training. Pretest scores for PGY 1, 2, 3, 4 were 3.5 (SD = 2.27, 95%CI: 2.13-5.00), 7.25 (SD = 6.70, 95%CI: 1.50-13.00), 10.75 (SD = 1.5, 95%CI: 9.50-12.00), 12.17 (SD = 2.57, 95%CI: 10.33-14.00). After simulation training PGY 1 residents did as well as well as the upper level residents. Posttest mean test scores for PGY 1, 2, 3, 4 were 13.75 (SD = 1.49, 95%CI: 12.75-14.63), 10.25 (SD = 0.24, 95%CI: 4.25-14.00), 15.00 (SD = 1.16, 95%CI: 14.00-16.00), 15.17 (SD = 0.75, 95%CI: 14.67-15.67).
CONCLUSION: Our simulation based training program not only produced short term gains, but participants were able to retain the skills learned and demonstrate their knowledge months later.
Core tip: In this article the authors investigated the use of the Gaumard's Noelle S550.100 Maternal and Neonatal Simulators for teaching forceps delivery. They describe the process of developing a simulation program, application, and evaluation at Banner Good Samaritan Medical Center. The intervention was successful in teaching resident physicians the steps of application, delivery and removal in forceps operative delivery. The authors hope is that their method may be applied in development of a variety of simulation based programs to improved education in obstetrics.