Simulation of childbirth improves clinical management capacity and self-confidence in medical students

Abstract

Background The learning process of physiological mechanisms of childbirth and its management are important elements in the education of medical students. In this study, we verify how the use of a high-fidelity simulator of childbirth improves competence of students in this regard. Methods A total of 132 medical students were recruited for the study in order to attend a physiological childbirth in a no-hospital environment after being assigned to two groups. The control group received only a normal cycle of lectures, while the simulation (SIM) group followed a specific training session on the simulator. Subsequently, both groups were assessed for their technical and non-technical skills in a simulated childbirth. Also, a self-assessment test regarding their self-confidence was administrated before and after simulation, and repeated after 8 weeks. Results The SIM group showed better performance in all the domains with a better comprehension of the mechanisms of childbirth, managing and assistance of labour and delivery. In addition, compared to the control group, they presented a better self-related awareness and self-assurance regarding the possibility of facing a birth by themselves. Conclusion The present study demonstrated that the use of a high-fidelity simulator for medical students allows a significant improvement in the acquisition of theoretical and technical expertise to assist a physiological birth.

Keywords: childbirth; no-technical skills; simulation; technical skills.

Figure 1

Experimental design of the study.

Figure 2

(A) Pretraining self-assessment test. (B) Post-training self-assessment test. Participants filled out a pretest to show their degree of confidence regarding childbirth before starting simulation. ***P<0.005 versus con. CON, control; SIM, simulation.

Figure 3

Technical (A) and non-technical skill evaluations (B). An external observer evaluated technical skills of the two groups (con and SIM) after simulation. ***P<0.005 versus con. Con, control; NTS scale, non-technical skill evaluation scale; SIM, simulation; TS scale, technical skill evaluation scale.

Figure 4

Total score on making decision and delivery: an external observer evaluated the final impact of simulation on birth considering TS scale and NTS scale together. ***P<0.005 versus con. Con, control; NTS scale, non-technical skill evaluation scale SIM, simulation; TS scale, technical skill evaluation scale.

Figure 5

Self-assessment test after scenario. Participants filled out a test after scenario training to show their degree of confidence regarding childbirth after performing simulation. *P<0.05 versus con. Con, control; SIM, simulation.

Figure 6

(A) Self-assessment test after scenario, (B) technical and (C) non-technical skill evaluation, (D) total score on making decision and delivery: participants repeated the tests after 8 weeks. *P<0.05 versus con. Con, control; NTS scale, non-technical skill evaluation scale SIM, simulation; TS scale technical skill evaluation scale.