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Simulation obstetric

Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
S Vigoureux, A Perreaud, G Legendre, D Salet-Lizée, R Villet
OBJECTIVES: For the treatment of prolapse, the vaginal route is less standardized than laparoscopy and seems abandoned by younger doctors. Our objectives were to evaluate the surgical experience of resident and youth gynecology and obstetrics assistants in pelviperineology and the level of confidence and mastery of the different surgical treatment of pelvic. METHODS: An anonymous questionnaire sent via an Internet platform interviewing residents and young assistants of gynecology and obstetrics (promotion 2005 to 2010) in France on their surgical training in pelviperineology...
October 14, 2016: Gynécologie, Obstétrique & Fertilité
Naola Austin, Sara Goldhaber-Fiebert, Kay Daniels, Julie Arafeh, Veronique Grenon, Dana Welle, Steven Lipman
As pioneers in the field of patient safety, anesthesiologists are uniquely suited to help develop and implement safety strategies to minimize preventable harm on the labor and delivery unit. Most existing obstetric safety strategies are not comprehensive, lack input from anesthesiologists, are designed with a relatively narrow focus, or lack implementation details to allow customization for different units. This article attempts to address these gaps and build more comprehensive strategies by discussing the available evidence and multidisciplinary authors' local experience with obstetric simulation drills and optimization of team communication...
October 3, 2016: Anesthesia and Analgesia
Samuel Smith
Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance...
October 12, 2016: Clinical Obstetrics and Gynecology
Jenni Burt, Gary Abel, Matt Barclay, Robert Evans, John Benson, Mark Gurnell
OBJECTIVE: To investigate the association between student performance in undergraduate objective structured clinical examinations (OSCEs) and the examination schedule to which they were assigned to undertake these examinations. DESIGN: Analysis of routinely collected data. SETTING: One UK medical school. PARTICIPANTS: 2331 OSCEs of 3 different types (obstetrics OSCE, paediatrics OSCE and simulated clinical encounter examination OSCE) between 2009 and 2013...
October 11, 2016: BMJ Open
A F Fransen, J van de Ven, E Schuit, Aac van Tetering, B W Mol, S G Oei
OBJECTIVE: To investigate whether simulation-based obstetric team training in a simulation centre improves patient outcome. DESIGN: Multicentre, open, cluster randomised controlled trial. SETTING: Obstetric units in the Netherlands. POPULATION: Women with a singleton pregnancy beyond 24 weeks of gestation. METHODS: Random allocation of obstetric units to a 1-day, multi-professional, simulation-based team training focusing on crew resource management (CRM) in a simulation centre or to no such team training...
October 10, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Kate L Mandeville, Godwin Ulaya, Mylène Lagarde, Adamson S Muula, Titha Dzowela, Kara Hanson
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not yet in specialty training. Over August 2012 to March 2013, 148 doctors took part out of 153 eligible in Malawi...
September 24, 2016: Social Science & Medicine
B O'Leary, A Khalid, M Higgins
Vaginal bleeding is a common event in early pregnancy, with 20-40% of pregnancies affected. Prompt diagnosis and management of bleeding is important, both to reduce morbidity and to avoid excessive emotional distress. This was a prospective study of an educational programme aimed at Obstetrics and Gynaecology BST trainees in the National Maternity Hospital, Dublin. The educational programme consisted of didactic lectures, and simulation and practical sessions. A questionnaire reviewing early pregnancy complications was used to assess participant knowledge...
2016: Irish Medical Journal
Marisa Gilstrop, Matthew K Hoffman
Shoulder dystocia continues to challenge obstetrical providers and therefore the management must evolve. The available literature demonstrates clear value in both simulation training and having a clear algorithmic approach. Similarly, the available literature suggests that delivery of the posterior arm should be prioritized. Several new techniques such as the Menticoglou maneuver, Gaskin's maneuver, and the posterior axilla sling traction technique offer obstetrical choices after more traditional techniques have failed...
December 2016: Clinical Obstetrics and Gynecology
P Raynal
Simulation in obstetrical emergency is in expansion. The important economic and human cost in simulation needs a real evaluation about enhancement in technical and non-technical skills, maternal and neonatal morbidity and mortality. We present a literature review of the results published on the subject in shoulder dystocia, post-partum haemorrhage, eclampsia and cord prolaps with a selection of publications with high evidence level or positive impact of training on obstetrical emergencies. There are few publications with a positive impact of training on obstetrical emergencies...
September 20, 2016: Gynécologie, Obstétrique & Fertilité
Saila Moni, Colleen Lee, Dena Goffman
Shoulder dystocia is a term that evokes terror and fear among many physicians, midwives, and health care providers as they recollect at least 1 episode of shoulder dystocia in their careers. Shoulder dystocia can result in significant maternal and neonatal complications. Because shoulder dystocia is an urgent, unanticipated, and uncommon event with potentially catastrophic consequences, all practitioners and health care teams must be well-trained to manage this obstetric emergency. Preparation for shoulder dystocia in a systematic way, through standardization of process, practicing team-training and communication, along with technical skills, through simulation education and ongoing quality improvement initiatives will result in improved outcomes...
September 21, 2016: Clinical Obstetrics and Gynecology
Lisa M Goldthwaite, Jeanelle Sheeder, Stephanie B Teal, Kristina M Tocce
OBJECTIVE: To estimate whether a standardized immediate postpartum intrauterine device (IUD) simulation results in sustained improvement in perceived comfort with procedural skills. METHODS: From November 2013 to April 2015, obstetric health care providers at two teaching hospitals participated in a 30-minute immediate postpartum IUD simulation workshop and program evaluation. We assessed knowledge of indications, insertion technique, safety, and comfort with knowledge and skills preintervention immediately after and 6 months posttraining...
October 2016: Obstetrics and Gynecology
Sarah Rae Easter, Roxane Gardner, Jon Barrett, Julian N Robinson, Daniela Carusi
OBJECTIVE: To describe a simulation-based curriculum on twin vaginal delivery and evaluate its effects on trainee knowledge and comfort about twin vaginal birth. METHODS: Trainees participated in a three-part simulation consisting of a patient counseling session, a twin delivery scenario, and a breech extraction skills station. Consenting trainees completed a 21-item presimulation survey and a 22-item postsimulation survey assessing knowledge, experience, attitudes, and comfort surrounding twin vaginal birth...
October 2016: Obstetrics and Gynecology
Laurice Bou Nemer, Dawn Kalin, Desiree Fiorentino, Jorge J Garcia, Christopher M Estes
OBJECTIVE: To develop and evaluate a simulation laboratory designed to stimulate learning and increase medical students' preparedness for an obstetrics and gynecology clinical clerkship. METHODS: Ninety-seven medical students participated in the games during their obstetrics and gynecology clerkship in 1 year. Using the resident-as-teacher model, students rotated through seven stations, each with a simulated obstetric task. Points were awarded at each station, and the student with the highest score won...
October 2016: Obstetrics and Gynecology
Angela K Shaddeau, Shad Deering
Shoulder dystocia is an unpredictable obstetric emergency that requires prompt interventions to ensure optimal outcomes. Proper technique is important but difficult to train given the urgent and critical clinical situation. Simulation training for shoulder dystocia allows providers at all levels to practice technical and teamwork skills in a no-risk environment. Programs utilizing simulation training for this emergency have consistently demonstrated improved performance both during practice drills and in actual patients with significantly decreased risks of fetal injury...
September 22, 2016: Clinical Obstetrics and Gynecology
Paolo Mannella, Giulia Palla, Armando Cuttano, Antonio Boldrini, Tommaso Simoncini
OBJECTIVE: To determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. METHODS: A prospective study was performed at a center in Italy in April-May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario...
August 27, 2016: International Journal of Gynaecology and Obstetrics
David Marzano, Roger Smith, Jill M Mhyre, F Jacob Seagull, Diana Curran, Sydney Behrmann, Kristina Priessnitz, Maya Hammoud
OBJECTIVE: To evaluate the implementation of a new clinical protocol utilizing on-unit simulation for team training. METHODS: A prospective observational study was performed at the obstetrics unit of Von Voightlander Women's Hospital, Michigan, USA, between October 1, 2012 to April 30, 2013. All members of the labor and delivery team were eligible for participation. Traditional education methods and in-situ multi-disciplinary simulations were used to educate labor and delivery staff...
August 27, 2016: International Journal of Gynaecology and Obstetrics
Shad H Deering, Laurie B Kavanagh, Michael K Chinn, Yong Choi, Robert M Rush, Imad Haque
OBJECTIVE: To assess the effects of deployment on basic laparoscopic skills of general surgeons and obstetrics/gynecology (OB/GYN) physicians. METHODS: This was a prospective 10-site study. Active duty Army OB/GYN and general surgery physicians scheduled to deploy were invited to participate. Before deployment, they performed fundamentals of laparoscopic surgery (FLS) tasks and specialty-specific procedures on a virtual reality laparoscopic simulator. Upon returning, physicians repeated the same evaluations...
September 2016: Military Medicine
Sean Copson, Katrina Calvert, Puvaneswary Raman, Elizabeth Nathan, Mathias Epee
BACKGROUND: Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. AIMS: This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval...
September 7, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Mohamed Elessawy, Moritz Skrzipczyk, Christel Eckmann-Scholz, Nicolai Maass, Liselotte Mettler, Veronika Guenther, Marion van Mackelenbergh, Dirk O Bauerschlag, Ibrahim Alkatout
OBJECTIVE: The primary objective of our study was to test the construct validity of the HystSim hysteroscopic simulator to determine whether simulation training can improve the acquisition of hysteroscopic skills regardless of the previous levels of experience of the participants. The secondary objective was to analyze the performance of a selected task, using specially designed scoring charts to help reduce the learning curve for both novices and experienced surgeons. DESIGN: The teaching of hysteroscopic intervention has received only scant attention, focusing mainly on the development of physical models and box simulators...
August 23, 2016: Journal of Surgical Education
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