Evaluation of the Patterns of Learning in the Labor Cervical Examination. Issue 6 (December 2019)

• Record Type: Journal Article
• Authors: Nitsche, Joshua F.; Goodridge, Elizabeth; Kim, Sung Min; Wong, Theresa; Brost, Brian C.
• Is Part Of: Simulation in healthcare. Volume 14:Issue 6(2019)
• Publication Date: 2019-12
• Subjects: Labor cervical exam -- labor and delivery -- simulation -- medical student -- resident -- obstetrics; Simulated patients -- Periodicals; 362.1
• DOI: 10.1097/SIH.0000000000000393
• Languages: English
• ISSNs: 1559-2332

Abstract

Abstract : Objective: The aim of the study was to evaluate patterns of skill acquisition in the labor cervical examination in novice providers, such as the change in accuracy and overestimation and underestimation over time and the impact of dilation and effacement on accuracy. Methods: In this descriptive longitudinal study, medical students each performed 120 simulated cervical examinations. Accuracy and how often students overestimated and underestimated dilation and effacement during was determined for each set of 10 repetitions. Accuracy data were grouped and compared by dilation (1–3, 4–6, and 7–10 cm) and effacement (90%, 75%, 50%, and 25%). Results: Student accuracy in dilation significantly improved throughout the course of the study ( P < 0.001). At the beginning of the study, students more often overestimated dilation, but this decreased over time ( P < 0.001). In addition, the accuracy of the students' estimations was 84%, 62%, and 52% for dilations of 1–3, 4–6, and 7–10 cm, respectively ( P < 0.001). Student accuracy in effacement significantly improved throughout the course of the study ( P < 0.001). At the beginning of the study, students more often overestimated effacement, but as training progressed, more students tended to overestimate and underestimate equally often ( P < 0.001). In addition, accuracy of the students' estimations was 93%, 88%, 81%, and 35% for effacements of 90%, 75%, 50%, and 25%, respectively ( P < 0.001). Conclusions: Knowing that students tend to overestimate cervical dilation and effacement early in training and that cervices of high dilation and low effacement are more difficult to assess will be helpful in designing more efficient cervical examination training regimens.