title: Exploratory randomized controlled trial of hybrid obstetric simulation training for undergraduate students.
abstract: BACKGROUND
  Introducing novel methods in undergraduate teaching of obstetrics and gynecology has been recommended. High-fidelity simulation of shoulder dystocia has been shown to improve skills of qualified maternity staff. We aimed to assess whether simulation is also useful for improving medical students' skills.
  
  
  METHODS
  Twenty-four medical students were recruited. Training consisted of a high-fidelity simulation teaching session for all 24 students and a refresher session for which the same students were randomly allocated to two groups. Half attended a small-group tutorial (SGT) and half a simulation session with a patient-actor (hybrid simulation, HYB). Afterward, they were asked to deliver a baby with simulated shoulder dystocia. We assessed their practical skills and compared communication skills between SGT and HYB. Primary outcome measure was their communication score, using a validated scale. Secondary measure was the students' ability to deliver the baby appropriately.
  
  
  RESULTS
  Posttraining, all students managed delivery appropriately. Group HYB had significantly higher median total patient perception scores (11 simulation versus 9 tutorial, P = 0.0239, Mann-Whitney) than SGT.
  
  
  CONCLUSIONS
  High-fidelity simulation can be used to train and evaluate learning. The use of patient-actors during simulation improves students' communication skills. Future research should assess whether this translates into better communication with real patients.
authors.affiliation: Bristol North Academy, University of Bristol, North Bristol NHS Trust, Bristol, UK. jsiasakos@gmail.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Siassakos
authors.forename: Timothy
authors.initials: T
authors.lastname: Draycott
authors.forename: Katherine
authors.initials: K
authors.lastname: O'Brien
authors.forename: Charlotte
authors.initials: C
authors.lastname: Kenyon
authors.forename: Christine
authors.initials: C
authors.lastname: Bartlett
authors.forename: Robert
authors.initials: R
authors.lastname: Fox
mesh_terms: D002983:Clinical Competence; D003142:Communication; D004420:Dystocia; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D006801:Humans; D017145:Models, Educational; D009774:Obstetrics / Q000193:education* / Q000379:methods; D016544:Patient Simulation; D011247:Pregnancy; D013337:Students, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D006113:United Kingdom