Abstract

Background: Operative vaginal delivery is a common obstetric intervention, with the potential to cause harm to mother and baby. Training in operative delivery traditionally comprised junior trainees learning the skills under supervision, then practicing and refining them independently. Recently this model has come under scrutiny, with the advent of simulation-based training suggesting a method by which the skills of safe delivery may be taught without risk. Multiple training courses exist, but few have been subjected to evaluation. Aims: The primary aim was to investigate if a simulation-based training workshop, where the development of a successful technique for vacuum delivery occurs using a collaborative, problem-solving approach, improves the rate of correct vacuum cup placement. The secondary aim was to determine if the workshop leads to improvement in theoretical knowledge of vacuum delivery. Methods: Participants on three workshops were assessed for their performance in vacuum delivery prior to and following a multimodal training program. Participants included general practitioner obstetricians, obstetric trainees and resident medical officers. Evaluation occurred using a standardised Likert-scaled rating sheet and utilising a diagrammatic representation of cup placement. Results: The participants demonstrated significant improvement (median post-pre score 1, p in the accuracy of cup placement, in a variety of practical core skills and in theoretical knowledge of vacuum delivery. Discussion: Participation in a simulation-based vacuum delivery workshop improves the performance of obstetric trainees and GP obstetricians. Further work is required to evaluate the performance of such training modalities on clinically relevant outcomes.

Highlights

  • Operative vaginal delivery is a core skill for obstetricians and General Practitioner obstetricians (GP obstetricians)

  • In a 2004 study from the UK, obstetricians recorded their perception of where the vacuum cup had been placed during a vacuum delivery on one form while on a second form a pediatrician indicated the actual site of the cup placement as observed on the baby [13]

  • Workshop data were collected on 36 workshop participants; 21 junior trainees (58.3%), 3 senior trainees (8.3%) and 12 GP obstetricians (33.3%)

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Summary

Introduction

Operative vaginal delivery is a core skill for obstetricians and General Practitioner obstetricians (GP obstetricians). Aims: The primary aim was to investigate if a simulation-based training workshop, where the development of a successful technique for vacuum delivery occurs using a collaborative, problem-solving approach, improves the rate of correct vacuum cup placement. Results: The participants demonstrated significant improvement (median post-pre score 1, p < 0.001) in the accuracy of cup placement, in a variety of practical core skills and in theoretical knowledge of vacuum delivery. Discussion: Participation in a simulation-based vacuum delivery workshop improves the performance of obstetric trainees and GP obstetricians. The workshop participants were invited to work out the steps required to achieve correct cup placement on the fetal head for each of the three different positions as previously discussed.

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