title: Does forceps training on a birth simulator allow obstetricians to improve forceps blade placement?
abstract: OBJECTIVE
  The aim of this study was to evaluate whether forceps training on a birth simulator allows obstetricians to improve forceps blade placement.
  
  
  METHODS
  Analysis was based on 600 forceps blade placements performed by ten trainees on a simulator. The trajectories used by the trainees were assessed using reference spheres that reflected an optimal bimalar placement. Three definitions of success were used: small-sphere success, medium-sphere success and large-sphere success were respectively defined by the forceps blade tip being within 5, 10 or 15mm of the center of the sphere (the small-sphere being nested within the medium-sphere and the small and medium being nested within the large-sphere). Wilcoxon paired analysis was performed to compare the first (50 trajectories) and final (50 trajectories) sets of five forceps placements. Graphical representation and linear regression were used to visualize the learning process.
  
  
  RESULTS
  596 trajectories were available for analysis. During the last set of five forceps the success rate was respectively 28%, 72% and 86% for small-sphere, medium-sphere and large-sphere success with the right blade and 8%, 32% and 70% for the left blade. Wilcoxon analysis showed a highly significant improvement for all kinds of success in the right blade and for large-sphere success in the left blade. Linear regression slopes were significant. Using a projection, the theoretical numbers of placements needed to achieve a 100% success rate for small-sphere, medium-sphere and large-sphere were respectively 80, 45 and 35.
  
  
  CONCLUSIONS
  These results strongly suggest that performing forceps blade placement on birth simulator allows obstetricians to improve their skills.
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Gynécologie Obstétrique, Pierre-Bénite, F-69495, France. olivier.dupuis@chu-lyon.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Dupuis
authors.forename: Evelyne
authors.initials: E
authors.lastname: Decullier
authors.forename: Jessica
authors.initials: J
authors.lastname: Clerc
authors.forename: Richard
authors.initials: R
authors.lastname: Moreau
authors.forename: Minh-Tu
authors.initials: MT
authors.lastname: Pham
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bin-Dorel
authors.forename: Xavier
authors.initials: X
authors.lastname: Brun
authors.forename: Michel
authors.initials: M
authors.lastname: Berland
authors.forename: Tanneguy
authors.initials: T
authors.lastname: Redarce
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000517:prevention & control; D005113:Extraction, Obstetrical / Q000193:education*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D009772:Obstetrical Forceps / Q000009:adverse effects*; D009774:Obstetrics / Q000193:education; D011361:Professional Competence; D055815:Young Adult