title: Does teaching of documentation of shoulder dystocia delivery through simulation result in improved documentation in real life?
abstract: OBJECTIVE
  Documentation of deliveries complicated by shoulder dystocia is a valuable communication skill necessary for residents to attain during residency training. Our objective was to determine whether the teaching of documentation of shoulder dystocia in a simulation environment would translate to improved documentation of the event in an actual clinical situation.
  
  
  METHODS
  We conducted a cohort study involving obstetrics and gynaecology residents in years 2 to 5 between November 2010 and December 2012. Each resident participated in a shoulder dystocia simulation teaching session and was asked to write a delivery note immediately afterwards. They were given feedback regarding their performance of the delivery and their documentation of the events. Following this, dictated records of shoulder dystocia deliveries immediately before and after the simulation session were identified through the Meditech system. An itemized checklist was used to assess the quality of residents' dictated documentation before and after the simulation session.
  
  
  RESULTS
  All eligible residents (18) enrolled in the study, and 17 met the inclusion criteria. For 10 residents (59%) documentation of a delivery with shoulder dystocia was present before and after the simulation session, for five residents (29%) it was only present before the session, and for two residents (18%) it was only present after the session. When residents were assessed as a group, there were no differences in the proportion of residents recording items on the checklist before and after the simulation session (P > 0.05 for all). Similarly, analysis of the performance of the10 residents who had dictated documentation both before and after the session showed no differences in the number of elements recorded on dictations done before and after the simulation session (P > 0.05 for all).
  
  
  CONCLUSIONS
  The teaching of shoulder dystocia documentation through simulation did not result in a measurable improvement in the quality of documentation of shoulder dystocia in actual clinical situations.
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.
authors.forename: Robyn
authors.initials: R
authors.lastname: Comeau
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.
authors.forename: Catherine
authors.initials: C
authors.lastname: Craig
mesh_terms: D015331:Cohort Studies; D004282:Documentation; D004420:Dystocia; D005260:Female; D006801:Humans; D007396:Internship and Residency; D009674:Nova Scotia; D009774:Obstetrics / Q000193:education*; D016544:Patient Simulation; D011247:Pregnancy; D058996:Quality Improvement; D012782:Shoulder; D013663:Teaching
keywords: documentation; shoulder dystocia; simulation