Checklist: A Useful and Safe Tool for the Initiation of Care for Eutocical Vaginal Delivery

Abstract

The aim of this study is to present and analyze the vaginal delivery checklist as a safe and useful learning tool for first-year residents in the gynecology and obstetrics and midwifery specialties at different hospitals and to analyze the items that comprise it and the progress of the residents during the first 30 normal deliveries attended in a supervised manner. We present a descriptive, observational and prospective study in which 18 participants from different hospitals in Spain completed a checklist of skills in the first 30 births attended autonomously after learning its use in a simulation workshop. We collected a total of 329 of 330 checklists completed by 11 participants. In addition, the mean responses for each item contained on the checklist and the mean global progression of the participants were subsequently analyzed, detecting statistically significant differences using Student's t-test for paired data. During the data collection period between September 2020 and August 2021, a total of 329 checklists were analyzed. The global average of positive responses for the 30 questions contained on the checklist was 25.36 out of 30 points. The fulfillment of the different items was variable, with the lowest fulfillment of 2.18 points, although 73% of the items obtained a score greater than 25. A statistically significant difference in the mean compliance of the first five childbirths compared to the last five deliveries using the proposed checklist was obtained, with p < 0.01. In conclusion, knowing the importance of using a checklist to anticipate risk situations and reduce the number of adverse perinatal outcomes, we can say that, for first-year residents in gynecology and obstetrics attending a clinical simulation workshop in eutocic vaginal delivery, it may be interesting to have a tool, such as the checklist proposed in this study, that facilitates the learning process and the suitable progress of the participants.

Keywords: checklist; eutocic vaginal delivery; learning; obstetrics; simulation.

Figure 1

SW-EVD phases. Each of the activities to be performed by the gynecology and obstetrics residents in each phase is described.

Figure 2

Mean number of positive responses completed on the CL for each item.

Figure 3

Mean CL completion for each delivery by all participants (mean of “Yes” answers for each completed CL during the first 30 deliveries). The global mean (continuous black line) of the first 30 deliveries of all participants is shown. The dashed black lines represent the 5th and 95th percentiles of mean CL completion in the first 30 births for all participants. The rest of the dashed lines of different colors reflect the individual trajectory of each participant during their care for their first 30 deliveries.

Figure 4

Percentage of students showing improvement and analysis of each item, after comparing the mean of “Yes” responses between the first five and last five CLs completed.