Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program
| Autor: | Aisha Abo El Ela, Johanna Buechel, Cécile Monod, Stefan Gisin, Irene Hoesli, Deborah R. Vogt |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Wilcoxon signed-rank test Pilot Projects Likert scale 03 medical and health sciences 0302 clinical medicine Clinical work Pregnancy medicine Humans Fetal head Prospective Studies 030212 general & internal medicine Simulation Training 030219 obstetrics & reproductive medicine Cesarean Section business.industry Obstetrics and Gynecology Checklist Clinical algorithm Breech extraction Obstetrics Pediatrics Perinatology and Child Health Physical therapy Female Training program business |
| Zdroj: | Journal of Perinatal Medicine. 47:857-866 |
| ISSN: | 1619-3997 0300-5577 |
| DOI: | 10.1515/jpm-2019-0216 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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