title: Assessment of a simulation training exercise to teach intrauterine tamponade for the treatment of postpartum hemorrhage.
abstract: BACKGROUND
  Postpartum hemorrhage is a common complication of vaginal birth. Few midwives have experience in the performance of procedures to manage hemorrhage that fails to respond to initial management with medications and bimanual compression.
  
  
  METHODS
  A simulation model was constructed by using a half-pelvis birth simulator and a hollowed out cantaloupe. Practicing midwives and students participated in a simulation exercise by using uterine packing and placement of a uterine tamponade balloon. Pre-exercise and post-exercise self-assessments were performed. Data were analyzed by using the Wilcoxon matched pairs signed rank test.
  
  
  RESULTS
  A total of 25 learners participated in the training session. All 25 participants showed improvement in their self-assessed competency level for the placement of the Bakri Postpartum Balloon (P < .001), and 24 of 25 showed improvement in self-assessed competency levels for uterine packing (P < .001).
  
  
  CONCLUSIONS
  An inexpensive simulation model can be used to effectively train midwives to treat postpartum hemorrhage by using methods of exerting direct pressure to the uterine cavity.
authors.affiliation: West Virginia University School of Medicine, Department of Obstetrics and Gynecology, Morgantown, WV 26506-9186, USA. MStitely@hsc.wvu.edu
authors.forename: Michael L
authors.initials: ML
authors.lastname: Stitely
authors.forename: Lena
authors.initials: L
authors.lastname: Cerbone
authors.forename: Angelita
authors.initials: A
authors.lastname: Nixon
authors.forename: Jay J
authors.initials: JJ
authors.lastname: Bringman
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004506:Education, Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D008880:Midwifery / Q000193:education*; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D018709:Statistics, Nonparametric; D058738:Uterine Balloon Tamponade