Simulation to Teach Cesarean Section and Hemorrhage Management: Evaluation of a Novel High-Fidelity Simulator [38G]. (May 2020)

• Record Type: Journal Article
• Authors: Foglia, Lisa M.; Eubanks, Allison; Peterson, Logan; Hickey, Kimberly; Jackson, Amanda; Deering, Shad
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000664972.70722.e7
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: The cesarean delivery the most common surgical procedure performed within the military health system (MHS). The gold standard for training physicians to perform a cesarean section is didactics and then practicing on actual patients. The objective of this study is to evaluate the efficacy of a novel high-fidelity simulator to train physicians with limited surgical obstetric experience to perform cesarean sections and manage operative hemorrhage. METHODS: Gynecology, family medicine, and surgery residents were recruited for the IRB approved study. All participants received the same didactic training on performing a cesarean section and managing postpartum hemorrhage. The intervention group received additional training on a simulator to perform the procedure and management of hemorrhage. All participants were then evaluated on their ability to perform a cesarean section with operative complications using the simulator. RESULTS: From July 2017 to January 2019 a total of 33 participants were recruited and randomized. The intervention group had higher scores on the cesarean delivery (p-values 0.013 and 0.017), hemorrhage management (p-value .0002), and overall skill (p-value .008). There was no difference in preoperative management, postoperative management, counseling, technical skills, and teamwork. CONCLUSION: Participants who received training using a high-fidelity simulator performed significantly better on all procedural aspects of a cesarean section and hemorrhage management. Simulation allows trainees to gain procedural experience while eliminating patient risk. Cesarean section simulators may be useful to train and reinforce surgical skills for residents, military physicians about to deploy, ancillary providers in low-resource settings, and physicians at low-volume medical centers.