Using Interprofessional OSCE-Based Simulation Collaboration to Teach Obstetrics to Second-Year Medical Students

Abstract

BACKGROUND: We have shown that it is possible to introduce an obstetric simulation program to preclinical 2nd-year medical students. In the second year of our obstetrics simulation curriculum for 2nd-year medical students, we introduced OSCE assessment in collaboration with the nursing school educator with the program occurring in the nursing school simulation center in November 2015. METHODS: Students rotated through three stations: 1) simulated vaginal delivery demonstrated by nurse educator and OBGYN resident; 2) MFM faculty gave interactive presentation on fetal heart rate (FHR), a student nurse then role played with students and they were assessed by OSCE format; and 3) OBGYN resident and faculty taught and assessed students on cervical dilation using cervical models. Students completed surveys on attitude, knowledge before, after and 7 months postcurriculum. RESULTS: Of 95 students, mean scores for the FHR OSCE were: identifies FHR baseline=0.97, identifies FHR variability=0.92, provides accurate identification of periodic pattern=0.73, identifies FHR category=0.67 and orders appropriate medical interventions=0.93. For the cervical station OSCE, the mean score on cervical examination skills after training was 75%. For the knowledge questions on obstetrics and fetal heart rate monitoring, students obtained a mean prescore of 2.57±0.09, postsimulation the mean score increased to 3.24±0.11 (P=.12). Presimulation; students scored their comfort level with obstetric procedures as 12.2±0.63, after simulation the mean score increased to 28±0.63 (P<.001). DISCUSSION: We have demonstrated the feasibility of an OSCE-based inter-professional educational curriculum utilizing nursing, physician and resident faculty instructing medical students and nursing students jointly. For FHR teaching, the concept of FHR category was the most challenging for the students to grasp. The course improved students' short-term knowledge but had dropped back to baseline by 7 months. Students' comfort level increased immediately posttraining and decreased but was still higher than baseline at 7 months. Further curriculum development is undergoing on increasing long term knowledge gain.