Training for shoulder dystocia: a trial of simulation using low-fidelity and high-fidelity mannequins.
نویسندگان
چکیده
OBJECTIVE To evaluate the effectiveness of simulation training for shoulder dystocia management and compare training using a high-fidelity mannequin with that using traditional devices. METHODS Training was undertaken in six hospitals and a medical simulation center in the United Kingdom. Midwives and obstetricians working for participating hospitals were eligible for inclusion. One hundred forty participants (45 doctors, 95 midwives) were randomized to training with a high-fidelity training mannequin (incorporating force perception training) or traditional low-fidelity mannequins. Performance was assessed pre- and posttraining, using a videoed, standardized shoulder dystocia simulation. Outcome measures were delivery, head-to-body delivery time, use of appropriate and inappropriate actions, force applied, and communication. RESULTS One hundred thirty-two participants completed the posttraining assessment. All training was associated with improved performance: use of basic maneuvers 114 of 140 (81.4%) to 125 of 132 (94.7%) (P=.002), successful deliveries 60 of 140 (42.9%) to 110 of 132 (83.3%) (P<.001), good communication with the patient 79 of 139 (56.8%) to 109 of 132 (82.6%) (P<.001), pre- and posttraining, respectively. Training with the high-fidelity mannequin was associated with a higher successful delivery rate than training with traditional devices: 94% compared with 72% (odds ratio 6.53, 95% confidence interval 2.05-20.81; P=.002). Total applied force was significantly lower for those who had undergone force training (2,030 Newton seconds versus 2,916 Newton seconds; P=.006) but there was no significant difference in the peak applied force 102 Newtons versus 112 Newtons (P=.242). CONCLUSION This study verifies the need for shoulder dystocia training; before training only 43% participants could achieve delivery. All training with mannequins improved the management of simulated shoulder dystocia. Training on a high-fidelity mannequin, including force perception teaching, offered additional training benefits. LEVEL OF EVIDENCE I.
منابع مشابه
Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial.
OBJECTIVE To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. DESIGN Cluster randomised controlled trial. SETTING The Netherlands. SAMPLE The obstetric departments of 24 Dutch hospitals. METHODS The obstetric departments were randomly assigned to a 1...
متن کاملAirway simulators and mannequins: a case of high infidelity?
M Y grandfather, a lieutenant colonel in the United States Air Force (USAF), was responsible for the training of all civilian mechanics in the USAF from 1948 to 1952. In this position, he received reports of injuries to his mechanics from around the world and knew well how tools were misused. I was reminded of his aphorism as I read the article by Schebesta et al. in this month’s ANESTHESIOLOGY...
متن کاملSimulation training in endotracheal intubation in a pediatric residency.
BACKGROUND Airway management and endotracheal intubation are essential skills for pediatric residents. Simulation-based technology is used for training residents but it remains unclear whether high fidelity simulation results in better retention of skills compared to low fidelity. The study assesses high fidelity simulation of endotracheal intubation and traditional low fidelity training in imp...
متن کاملThe Utilization of High Fidelity Simulation in the Support of UAV Launch Phase Design: Three Case Studies
Improvement of the launch phase of a jet powered Unmanned Aerial Vehicle (UAV) with Jet Assisted Take Off (JATO), has been the subject of attention in the UAV industry. Use of flight simulation tools reduces the risk and required some amount of flight testing for complex aerospace systems. Full nonlinear equations of motion are used to study and simulate this maneuver and three case studies of ...
متن کاملHigh-fidelity patient simulation mannequins to facilitate aerodigestive endoscopy training.
OBJECTIVE To evaluate the perceived value of aerodigestive endoscopy training using high-fidelity simulation. DESIGN Self-reported survey. SETTING Pediatric tertiary care hospital. PARTICIPANTS Consecutive sample of otolaryngology residents and 1 fellow during the 2006-2007 academic year. INTERVENTIONS Foreign body aspiration and ingestion were simulated in a high-fidelity, computer-ass...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Obstetrics and gynecology
دوره 108 6 شماره
صفحات -
تاریخ انتشار 2006