Simulation-Based Curriculum is Effective in Teaching Principles of Vaginal Breech Delivery
ACOG ePoster. Higgins E. Apr 27, 2018; 211798; 35M
Erin Higgins
Erin Higgins
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Introduction: Simulation has yet to be fully implemented into the curriculum in many obstetrics and gynecology residencies across the U.S. Reasons for resistance to implementation include cost, time requirements both of instructors and learners, and a paucity of data demonstrating the benefit of simulation with regards to skills training. Advocates of simulation in residency training note its value in teaching high-acuity, low-frequency events such as vaginal breech delivery.

Methods: We implemented a one year simulation curriculum incorporating obstetric and gynecologic skills training, standardized patient encounters, and teamwork training. Residents at all levels participated in the training sessions, which were a mandatory part of the educational curriculum. End-of-the-year evaluation was accomplished through the use of a two-hour practical exam in which residents performed skills at 13 different stations. Faculty evaluations of residents were collected for each station using an objective skills card that scored both clinical knowledge and procedural skills.

Results: We found that residents' performance at the vaginal breech station improved consistently over 3 years of data collection. The junior cohort improved from 70.0% to 83.3% proficiency from PGY-1 to PGY-3, while a more senior cohort improved from 78.6% to 84.6% from PGY-2 to PGY-4. An third cohort that began the curriculum in the PGY-3 year improved from 90.4% to 91.6%.

Conclusion/Implications: This pilot study demonstrates that a simulation-based educational curriculum is an effective method of teaching residents procedural skills and knowledge to improve competency in the area of vaginal breech deliveries.
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