title: Obstetric forceps training using visual feedback and the isometric strength testing unit.
abstract: OBJECTIVE
  This is a descriptive study that tested the maximum traction residents could apply to forceps during simulations. Visual feedback was then used to reinforce an optimal range of traction, and the ability of residents to reproduce this pull when blinded was assessed.
  
  
  METHODS
  Fifty-five residents participated in 6 pulling exercises using an isometric strength testing unit with a real-time computer printout of the force applied. Maximum traction was determined for male and female residents in standing and sitting positions. Visual feedback was then used to estimate whether residents could be trained to reproduce an optimal force range of 30-45 pounds. Data were analyzed using a repeated measures analysis of variance.
  
  
  RESULTS
  When asked to produce a maximum pull, male residents could generate significantly more force than females in the standing and sitting positions (P < .001). In general, all residents of both sexes generated more traction in the sitting position than in the standing position. The mean maximum traction produced by men in the standing and sitting positions was 69.5 and 85.8 pounds, respectively. For women, the mean maximum force generated was 45.5 pounds in the standing position and 61.3 pounds in the sitting position. Residents could easily reproduce an appropriate force in the short term after training by computer-assisted visual feedback.
  
  
  CONCLUSIONS
  Motor learning tasks using visual feedback can be useful in training practitioners to produce appropriate traction forces during obstetric forceps deliveries. Residents of both sexes, but especially men, can generate traction forces exceeding the recommended limit. Unless tempered by training, forces generated from the sitting position in particular can often exceed the preferred range.
  
  
  METHODS
  II-3.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, the University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA. kleslie@salud.unm.edu
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Leslie
authors.forename: Pamela
authors.initials: P
authors.lastname: Dipasquale-Lehnerz
authors.forename: Marcia
authors.initials: M
authors.lastname: Smith
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D036861:Delivery, Obstetric / Q000193:education / Q000295:instrumentation*; D004503:Education, Medical, Graduate; D005246:Feedback; D005260:Female; D018737:Hand Strength; D006801:Humans; D007396:Internship and Residency; D007537:Isometric Contraction / Q000502:physiology; D008297:Male; D009772:Obstetrical Forceps; D009774:Obstetrics / Q000193:education; D011336:Probability; D012680:Sensitivity and Specificity; D012737:Sex Factors