Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program.
| Autor: | Monod, Cécile, Buechel, Johanna, Gisin, Stefan, Abo El Ela, Aisha, Vogt, Deborah R., Hoesli, Irene |
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| Předmět: |
HEAD surgery
EDUCATION of physicians HOSPITAL medical staff ALGORITHMS BREECH delivery CESAREAN section CLINICAL competence COMPUTER simulation CONCEPTUAL structures CONFIDENCE LABOR (Obstetrics) MATHEMATICAL models OBSTETRICAL emergencies QUESTIONNAIRES SCALE analysis (Psychology) THEORY EVALUATION of human services programs MANN Whitney U Test EDUCATION |
| Zdroj: | Journal of Perinatal Medicine; Oct2019, Vol. 47 Issue 8, p857-866, 10p, 2 Diagrams, 2 Charts, 3 Graphs |
| Abstrakt: | Background: Although cesarean sections at full dilatation are increasing, training in delivering a deeply impacted fetal head is lacking among obstetricians. The purpose of the study was to implement and evaluate a theoretical and simulation-based training program for this obstetrical emergency. Methods: We developed a training program consisting of a theoretical introduction presenting a clinical algorithm, developed on the basis of the available literature, followed by a simulation session. We used the Kirkpatrick's framework to evaluate the program. A questionnaire was distributed, directly before, immediately and 6 weeks after the training. Self-perceived competencies were evaluated on a 6-point Likert scale. Pre- and post-test differences in the Likert scale were measured with the Wilcoxon signed rank test. Additionally, the training sessions were video recorded and rated with a checklist in relation to how well the algorithm was followed. Results: Eleven residents and eight senior physicians took part to the training. More than 40% of participants experienced a comparable situation after the course during clinical work. Their knowledge and self-perceived competencies improved immediately after the training program and 6 weeks later. Major improvements were seen in the awareness of the algorithm and in the confidence in performing the reverse breech extraction (14.3% of the participants felt confident with the maneuver in the pre-training assessment compared with 66.7% 6 week post-training). Conclusion: Our theoretical and simulation-based training program was successful in improving knowledge and confidence of the participants in delivering a deeply impacted fetal head during a cesarean section performed at full dilation. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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