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. 2015 Feb;125(2):369-374.
doi: 10.1097/AOG.0000000000000622.

Assessment of a full dilatation cesarean delivery simulator

Nicola Vousden  1 , Zoya Hamakarim, Annette Briley, Joanna Girling, Paul T Seed, Graham Tydeman, Andrew H Shennan
Affiliations

Assessment of a full dilatation cesarean delivery simulator

Nicola Vousden et al. Obstet Gynecol. 2015 Feb.

Abstract

Objective: To assess a full dilatation cesarean delivery simulator and to establish expert consensus on the most effective techniques for safe delivery.

Methods: Three delivery scenarios with increasing degrees of difficulty were tested. Face and content validity were assessed using visual analog scale (VAS) scores on how realistic the simulator was and how useful it would be for training, respectively. Construct validity was assessed by comparing success at delivery and time taken between senior doctors and junior doctors. Expert opinion was sought through a questionnaire.

Results: The training scenarios were undertaken by 30 doctors working in the specialty of obstetrics and gynecology. The number of participants able to deliver and the perceived difficulty they experienced correlated with the difficulty level of the three scenarios (success: scenario 1, 100% [n=30]; scenario 2, 90% [n=27]; and scenario 3, 62% [n=16] P<.05; mean VAS: scenario 1, 29/100; scenario 2, 42/100; and scenario 3, 88/100; P<.001). Average time to delivery for each scenario was 45 seconds, 43 seconds, and 109 seconds, respectively (P<.001). Overall, 87% found the simulator to be realistic (median VAS 58/100, interquartile range 40-74) and 93% thought it would be useful as a training device (median VAS 80/100, interquartile range 55-97). Questionnaires were received from 47 consultants with an average of 18 years of experience. High uterine incision and assistance to push the fetal head up transvaginally were the only two techniques reported by more than half of the respondents.

Conclusion: This full dilatation cesarean delivery simulator has been validated as a training device; we believe it should be used to develop a consensus for accepted techniques.

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References

    1. Martin JA, Hamilton BE, Osterman MJK, Curtin SC, Mathews TJ. Births: final data for 2012. Natl Vital Stat Rep 2013;62:9.
    1. Unterscheider J, McMenamin M, Cullinane F. Rising rates of caesarean deliveries at full cervical dilatation: concerning trend. Eur J Obstet Gynaecol Reprod Biol 2011;157:141–4.
    1. Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet 2001;358:1203–7.
    1. Sethuram R, Jamjute P, Kevelighan E. Delivery of the deeply engaged head: a lacuna in training. J Obstet Gynaecol 2010;30:545–9.
    1. Macedonia CR, Gherman RB, Satin AJ. Simulation laboratories for training in obstetrics and gynecology. Obstet Gynecol 2003;102:388–92.

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