title: Improving shoulder dystocia management among resident and attending physicians using simulations.
abstract: OBJECTIVE
  The objective of the study was to determine whether a simulation-based educational program would improve residents' and attending physicians' performance in a simulated shoulder dystocia.
  
  
  METHODS
  Seventy-one obstetricians participated in an unanticipated simulated shoulder dystocia, an educational debriefing session, and a subsequent shoulder dystocia simulation. Each simulation was scored, based on standardized checklists for 4 technical maneuvers and 6 communication tasks, by 2 physician observers. Paired Student t tests were used for analysis.
  
  
  RESULTS
  Forty-three attendings and 28 residents participated. Residents showed significant improvement in mean maneuver (3.3 +/- 0.9 vs 3.9 +/- 0.4, P = .001) and communication (3.5 +/- 1.2 vs 4.9 +/- 1.0, P < .0001) scores after simulation training. Attending physicians' communication (3.6 +/- 1.6 vs 4.9 +/- 1.1, P < .0001) scores were significantly improved after training.
  
  
  CONCLUSIONS
  Our program improved physician performance in the management of simulated shoulder dystocia deliveries. Obstetric emergency simulation training can improve physicians' communication skills, at all levels of training, and should be incorporated into labor and delivery quality improvement measures.
authors.affiliation: Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA. dgoffman@montefiore.org
authors.forename: Dena
authors.initials: D
authors.lastname: Goffman
authors.forename: Hye
authors.initials: H
authors.lastname: Heo
authors.forename: Setul
authors.initials: S
authors.lastname: Pardanani
authors.forename: Irwin R
authors.initials: IR
authors.lastname: Merkatz
authors.forename: Peter S
authors.initials: PS
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000193:education*; D004420:Dystocia / Q000628:therapy*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D012782:Shoulder