Improving resident competency in the management of shoulder dystocia with simulation training

Abstract

Objective: To determine whether a simulation training scenario improves resident competency in the management of shoulder dystocia.

Methods: Residents from 2 training programs participated in this study. The residents were block-randomized by year-group to a training session on shoulder dystocia management that used an obstetric birthing simulator or to a control group with no specific training. Trained residents and control subjects were subsequently tested on a standardized shoulder dystocia scenario, and the encounters were digitally recorded. A physician grader from an external institution then graded and rated the resident's performance with a standardized evaluation sheet. Statistical analysis included the Student t test, chi(2), and regression analysis, as appropriate.

Results: Trained residents had significantly higher scores in all evaluation categories, including timelines of their interventions, performance of maneuvers, and overall performance. They also performed the delivery in a shorter time than control subjects (61 versus 146 seconds, P =.003).

Conclusion: Training with a simulation-training scenario improved resident performance in the management of shoulder dystocia.

Level of evidence: I