Abstract
INTRODUCTION: Obstetric hemorrhage is the leading cause of maternal mortality in Rwanda. Retention of skills was assessed 2 years after a postpartum hemorrhage simulation training at a rural Rwandan hospital. METHODS: In 2012, two African generalist physicians working in a rural Rwandan hospital conducted simulation-based training in postpartum hemorrhage management for their colleagues. These 11 physicians were approached again in 2014 and asked to participate in the current study. Retention simulation drills were conducted using the same simulation scenario as in the initial training. Median scores and interquartile ranges were calculated. The Wilcoxon signed-rank-sum test was used to compare preintervention and postintervention scores and retention scores in three performance areas: communication, evaluation, and management. RESULTS: Six of the original 11 participants were available and consented to participate. Comparisons of the preintervention and 2-year retention scores in each of three performance areas revealed retention-of-skill scores that were not significantly different than the postintervention scores after the original simulation training: median (interquartile range) preintervention compared with retention communication: 0.5 (0, 2) compared with 3.5 (2, 4) (P=.03) and postintervention compared with retention communication: 3.5 (3, 4) compared with 3.5 (2, 4) (P=1.0); preintervention compared with retention evaluation: 2 (2, 4) compared with 5 (4, 5) (P=.03) and postintervention compared with retention evaluation: 4.5 (2, 5) compared with 5 (4, 5) (P=.16); and preintervention compared with retention management: 2.5 (2, 5) compared with 7 (7, 10) (P=.09) and postintervention compared with retention management: 10 (7, 12) compared with 7 (7, 10) (P=.46). CONCLUSION: Simulation-based training may be an effective method for teaching communication, evaluation, and management skills for postpartum hemorrhage in rural Africa.
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