Start/Search | Browse by Day | Author Index

Successful management of obstetrical emergencies requires the coordinated efforts of a multidisciplinary team of professionals. Simulation training provides an opportunity to learn and master simple as well as complex technical skills needed in emergent situations.  “Simulation as a teaching and learning method provides innovative educational experiences to assess and develop clinical competency, promote teamwork, and improve care processes” (Nagle et al. 2009, p. 18).

Research indicates that simulation training improves performance with actual patients.  For example, evidence supporting the use of simulation training from a randomized study by Deering et al. (2004), found residents trained using simulation training to practice high risk scenarios demonstrated the ability to resolve shoulder dystocia in less time during practice drills than residents who were not trained to use simulation scenarios for learning (61 ± 47.4 vs. 146 ± 93.0 s, p = .003). Another study by Jude, Gilbert, and Magrane in 2006 demonstrated that students who practiced deliveries on simulators reported higher levels of confidence in their skills to perform deliveries.

The Institute of Medicine (IOM) in the report, To Err is Human: Building a Safer Health System (2001) urged health care providers to focus on strategies to enhance teamwork among clinicians. The IOM recommends that health care organizations make interdisciplinary teamwork a core competency and establish team training programs that incorporate simulation as a part of their patient safety programs.  The Joint Commission (2004) also recommends team training in perinatal areas to promote effective teamwork and improved communication.

Simulation training incorporates the principles of adult learning of several educational theorists.  Rogers (1969) for example postulates that students learn best in a non threatening environment. Knowles (1970) suggests that adult learners are motivated when they actively participate in the learning process, learn to problem solve and immediately apply what has been learned.  Kolb’s experiential learning theory defines “learning as a process by which knowledge is created through the transformation of experience” (1984, p.38).

With a birth rate over 7,000 annually, our healthcare system designed a simulation training program to improve the management of OB emergencies. Shoulder dystocia, the first emergency used for simulation training requires immediate recognition and well coordinated teamwork to enhance mother/ infant outcomes. Our training sessions implement such concepts as role clarity, communication, assessment skills, and response time. The 4-hour program includes didactic, role-play, and debriefing sessions. The simulation lab is set up in an actual labor and delivery suite and scenarios are presented to maximize high-fidelity simulation for class participants. Debriefing, a key component of simulation training, provides opportunity for dialogue, self-reflection, and feedback in a non-threatening environment.

Simulation training is a useful teaching method for healthcare providers at all levels of experience. Our program helps to enhance the application of knowledge, the utilization of complex decision making and the development of clear communication skills. Future educational opportunities include postpartum hemorrhage, precipitous and breech deliveries, and integration into the orientation curriculum for new staff.