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06-09-2011 | Gynaecology | Article

Simulation training improves obstetrics students’ confidence, grades


Free abstract

MedWire News: Obstetrics students perform better at their end-of-rotation exams if they are exposed to a vaginal delivery simulation during their training as well as a formal lecture, show study results.

The medical students who received simulation training were also more confident in their ability to perform a vaginal delivery, compared with students who did not receive the training.

"Simulation training allows learners to make mistakes in a controlled setting and to repeat the simulation or skills multiple times," explain Shelly Holmström (University of South Florida, Tampa, USA) and colleagues in the journal Obstetrics and Gynecology.

"The simulation training engaged the students early on. As a result, they may have been more invested in the clerkship and absorbed the information more effectively and comprehensively," added Holmström.

A total of 113 students rotating in the maternal newborn clerkship between 2010 and 2011 at the University of South Florida participated in the study. Of these, 56 were randomly assigned to receive simulation training in addition to a formal lecture.

The simulator-trained students were split into groups of four to six, and had a practice session using a Noelle obstetrics simulator (Gaumard Scientific, Miami, USA). Each student performed at least one vaginal delivery using the simulator, which included scenarios such as delivery of the fetal shoulders and assessing lacerations.

Students completed a baseline questionnaire that assessed their knowledge of vaginal delivery and their confidence to perform various elements. The questionnaire was also completed after the lecture, the simulation, their first three deliveries, and at the end of the 4-week rotation.

The questionnaire results produced immediately after the lecture or lecture plus simulation showed that the simulator-trained students were significantly more confident (defined as a response of "with minimal supervision" or "independently" rather than "not at all" or "with close supervision") in their ability to perform a vaginal delivery than the lecture-only students.

Simulator-trained students were also significantly more confident in their ability to control the fetal head, deliver the shoulders, fetal shoulders, and placenta, and examine the placenta and extent of lacerations, compared with lecture-only students.

Overall, 52.6% of simulator-trained students felt they could perform a delivery independently or with minimal supervision, while just 16.1% of lecture-only trained students felt this.

At subsequent assessments, however, there was no significant difference in confidence levels by training group, probably due to a ceiling effect, explain the researchers. "By the final survey, all of the students were reporting a high level of confidence," they write.

Finally, simulator-trained students scored significantly higher on their oral and written examinations 4 weeks after they had attended the lecture or lecture plus simulation.

"This relationship between simulation training and examination scores would make an intriguing topic for future research," conclude Holmström and co-authors.

By Sarah Guy