American Journal of Obstetrics and Gynecology
Meeting paperSMFM paperImproving shoulder dystocia management among resident and attending physicians using simulations
Section snippets
Materials and Methods
The study group consisted of resident and full-time faculty attending physicians at a large university-based hospital that cares for a diverse population. Participation in our obstetric simulation program was strongly encouraged by departmental leadership, and accommodations were made in physicians' clinical schedules to facilitate this. Simulations were performed using a combination of human actors and a modified Noelle full-sized female anthropomorphic robotic birth simulator (Gaumard
Results
Seventy-one of a potential 86 physicians (83%) completed the study. Exclusions were due to the following: 6 never able to attend because of scheduling, 8 completed 1 simulation but unable to complete their second simulation because of scheduling, and 1 refused participation. The study population included 43 attending physicians (61%) and 28 residents (39%). Subject ages ranged from 25 to 63 years (mean ± SD: 37.0 ± 9.0 years) and 75% were female. For attending physicians in our study, years of
Comment
Shoulder dystocia is an unpredictable obstetric emergency, which requires skillfull handling in an organized manner to avoid serious maternal and neonatal sequelae. Historically, shoulder dystocia management has been taught through reading and lectures. However, the first opportunity for a trainee to utilize maneuvers is often during an actual emergency. From a patient perspective, the best person to deal with a dystocia delivery is the most experienced provider available, leaving us with the
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2016, Nursing for Women's HealthCitation Excerpt :Positive outcomes of simulation learning include evaluating the consistency of practice and policy as well as system function (Andreatta, Frankel, Boblick Smith, Bullough, & Marzano, 2011; AHRQ, 2013b; Ennen & Satin, 2010; Guise et al., 2010). Data suggest that simulation education is associated with fewer errors, better communications, enhanced team work, increased confidence, improved women’s health outcomes, higher learner satisfaction, increased critical thinking, retention of skills and knowledge, efficient learning, lower malpractice claims, and more accurate self-evaluation among nurses, physicians, medical residents, and students (AHRQ, 2013a, 2013b; Cass, Crofts, & Draycott, 2011; Cooper et al., 2012; Ennen & Satin, 2010; Gardner, Walzer, Simon, & Raemer, 2008; Goffman, Heo, Pardanani, Merkatz, & Bernstein, 2008; Gough, Hellaby, Jones, & MacKinnon, 2012; Grunebaum, Chervenak, & Skupski, 2011; Jeffries et al., 2009; Merién, van de Ven, Mol, Houterman, & Oei, 2010). Given simulation’s value, The Joint Commission has recommended it as a risk reduction strategy to ameliorate root causes of both maternal death (The Joint Commission, 2010) and infant death and injury during birth (The Joint Commission, 2004).
Cite this article as: Goffman D, Heo H, Pardanani S, et al. Improving shoulder dystocia management among resident and attending physicians using simulations. Am J Obstet Gynecol 2008;199:294.e1-294.e5.