title: Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration.
  
  
  METHODS
  We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis.
  
  
  RESULTS
  Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores.
  
  
  CONCLUSIONS
  Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model.
  
  
  BACKGROUND
  www.ClinicalTrials.gov, NCT01618565.
  
  
  METHODS
  I.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Buerkle
authors.forename: Julia
authors.initials: J
authors.lastname: Pueth
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Hefler
authors.forename: Eva-Katrin
authors.initials: EK
authors.lastname: Tempfer-Bentz
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D000465:Algorithms; D002983:Clinical Competence; D003661:Decision Support Techniques; D036861:Delivery, Obstetric / Q000193:education* / Q000379:methods; D004420:Dystocia / Q000628:therapy*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008953:Models, Anatomic; D011247:Pregnancy; D013663:Teaching / Q000379:methods*