Simulation training and resident performance of singleton vaginal breech delivery.
OBJECTIVE
To determine whether simulation training improves resident competency in the management of a simulated vaginal breech delivery.


METHODS
Without advance notice or training, residents from 2 obstetrics and gynecology residency programs participated in a standardized simulation scenario of management of an imminent term vaginal breech delivery. The scenario used an obstetric birth simulator and human actors, with the encounters digitally recorded. Residents then received a training session with the simulator on the proper techniques for vaginal breech delivery. Two weeks later they were retested using a similar simulation scenario. A physician, blinded to training status, graded the residents' performance using a standardized evaluation sheet. Statistical analysis included the Wilcoxon signed rank test, McNemar chi2, regression analysis, and paired t test as appropriate with a P value of less than .05 considered significant.


RESULTS
Twenty residents from 2 institutions completed all parts of the study protocol. Trained residents had significantly higher scores in 8 of 12 critical delivery components (P < .05). Overall performance of the delivery and safety in performing the delivery also improved significantly (P = .001 for both).


CONCLUSIONS
Simulation training improved resident performance in the management of a simulated vaginal breech delivery. Performance of a term breech vaginal delivery is well suited for simulation training, because it is uncommon and inevitable, and improper technique may result in significant injury.


METHODS
II-2.
Deering
Shad
S
Madigan Army Medical Center, Tacoma, Washington, USA. deering95@hotmail.com
Brown
Jill
J
Hodor
Jonathon
J
Satin
Andrew J
AJ
D000328:Adult; D001946:Breech Presentation; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000193:education* / Q000379:methods; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009774:Obstetrics / Q000193:education; D016544:Patient Simulation; D011247:Pregnancy