title: Improving resident competency in the management of shoulder dystocia with simulation training.
abstract: OBJECTIVE
  To determine whether a simulation training scenario improves resident competency in the management of shoulder dystocia.
  
  
  METHODS
  Residents from 2 training programs participated in this study. The residents were block-randomized by year-group to a training session on shoulder dystocia management that used an obstetric birthing simulator or to a control group with no specific training. Trained residents and control subjects were subsequently tested on a standardized shoulder dystocia scenario, and the encounters were digitally recorded. A physician grader from an external institution then graded and rated the resident's performance with a standardized evaluation sheet. Statistical analysis included the Student t test, chi(2), and regression analysis, as appropriate.
  
  
  RESULTS
  Trained residents had significantly higher scores in all evaluation categories, including timelines of their interventions, performance of maneuvers, and overall performance. They also performed the delivery in a shorter time than control subjects (61 versus 146 seconds, P =.003).
  
  
  CONCLUSIONS
  Training with a simulation-training scenario improved resident performance in the management of shoulder dystocia.
  
  
  METHODS
  I
authors.affiliation: Department of Obstetrics and Gynecology, Georgetown University Hospital, 3-PHC, 3800 Reservoir Road NW, Washington, DC 20007, USA. deering95@hotmail.com
authors.forename: Shad
authors.initials: S
authors.lastname: Deering
authors.forename: Sarah
authors.initials: S
authors.lastname: Poggi
authors.forename: Christian
authors.initials: C
authors.lastname: Macedonia
authors.forename: Robert
authors.initials: R
authors.lastname: Gherman
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Satin
mesh_terms: D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000193:education*; D004420:Dystocia / Q000628:therapy*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008348:Manikins; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D012782:Shoulder