title: Effectiveness of Vaginal Delivery Simulation in Novice Trainees.
abstract: OBJECTIVE
  Simulation training has been demonstrated to increase medical student confidence with vaginal deliveries; however, effect on skill performance is still lacking. To determine if integration of simulation training into the OB/GYN clerkship improves performance of vaginal deliveries, we assessed the effectiveness of simulation in third-year medical students.
  
  
  METHODS
  During the OB/GYN clerkship, third-year students were assigned to receive vaginal delivery simulation (n=54) or cervical exam simulation (n=56), with each group serving as a simulation naïve control for the other skill. As a final assessment of their skill, students performed a simulated vaginal delivery scored by a blinded observer using a procedural checklist (score 0-30). A satisfactory score was considered 26 or greater. The individual scores and percentage of satisfactory scores were compared between both groups using a Mann-Whitney U test and chi-square test, respectively.
  
  
  RESULTS
  Vaginal delivery students had a significantly higher mean score (27 +/- 3.2) and percentage of students achieving a passing score (85%) than the cervical exam students (22 +/- 3.5 and 15%). There were no differences in vaginal delivery performance based on gender, nor was there any difference in the number of real-life deliveries performed between vaginal delivery and cervical exam students.
  
  
  CONCLUSIONS
  Even though medical students had an equivalent clinical rotation experience, a short period of simulation training had a marked effect on their end-of-rotation performance. During initial resident or midwife training more than 5 hours of simulation will likely be required to properly prepare 100% of trainees.
authors.affiliation: Division of Maternal Fetal Medicine, Department of OB/GYN, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Shumard
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Denney
authors.forename: Kristen
authors.initials: K
authors.lastname: Quinn
authors.forename: Arnold S
authors.initials: AS
authors.lastname: Grandis
authors.forename: Paul W
authors.initials: PW
authors.lastname: Whitecar
authors.forename: John
authors.initials: J
authors.lastname: Bailey
authors.forename: Rubymel J
authors.initials: RJ
authors.lastname: Jijon-Knupp
authors.forename: Chenchen
authors.initials: C
authors.lastname: Huang
authors.forename: Kendra
authors.initials: K
authors.lastname: Kesty
authors.forename: Brian C
authors.initials: BC
authors.lastname: Brost
authors.forename: Joshua F
authors.initials: JF
authors.lastname: Nitsche
mesh_terms: D000328:Adult; D002982:Clinical Clerkship / Q000379:methods; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000193:education*; D004521:Educational Measurement / Q000379:methods / Q000592:standards; D005260:Female; D006176:Gynecology / Q000379:methods; D006801:Humans; D008297:Male; D011247:Pregnancy; D000066908:Simulation Training / Q000379:methods*; D013337:Students, Medical / Q000523:psychology*