Trials of labour: Can simulation make a difference to obstetric anaesthetic training?

Abstract

Summary As a result of the move towards regional techniques, today's anaesthetic trainee has limited exposure to general anaesthesia for caesarean section. This is compounded by recent changes in working practice that restrict training hours. The latter also diminishes the trainee's exposure to common and to more rare obstetric emergencies. Management of obstetric emergencies requires not only technical skills but also good team working skills and this is rarely taught in traditional training programmes. In addition, the ethics of practicing regional techniques on patients when alternative learning tools are available are questionable. In this article we discuss the challenges facing trainers and trainees in obstetric anaesthesia. We propose a need for changes in training programmes to embed the use of simulation for training in both technical and human factors skills. The uses of epidural simulators, airway trainers, whole body patient simulators and emergency drill training in both the workplace and in specialized simulation centres are discussed. A potential role for simulation in assessment of trainees is also considered.