Knowledge reinforcement and learner satisfaction of simulation-based training versus image-based lectures for management of normal delivery and shoulder dystocia

Oral Presentation # 1 Knowledge reinforcement and learner satisfaction of simulationbased training versus image-based lectures for management of normal delivery and shoulder dystocia. Reynolds A 1 , Bastos LF 2 , Ayres-de-Campos D 1,2 , van Meurs WL 2,3 , Macedo-Pinto I 4 , 1 Departamento de Obstetrı´cia e Ginecologia, Centro de Simulac¸a˜o Biome´dica, Faculdade de Medicina, Universidade do Porto, 2 Instituto de Engenharia Biome´dica, Porto, 3 Department of Anesthesiology, University of Florida College of Medicine, USA, 4 Faculdade de Psicologia e de Cieˆncias da Educac¸a˜o, Universidade do Porto The aim of this study was to evaluate the impact on knowledge reinforcement and learner satisfaction of a simulation-based training session versus an image-based lecture, for normal delivery and shoulder dystocia management. Thirty training midwifes participated in the study. Three weeks after a 3-hour “labor and delivery” theoretical class, trainees were randomly assigned to one of two groups. Four were excluded after randomization. The first group (n⫽12) participated in a 30-minute image based lecture and the second group (n⫽14) was divided in pairs attending a 30-minute birthing simulator session (Noelle威, Gaumard, Inc., USA). Both classes focused on management of normal delivery and manoeuvres for shoulder dystocia resolution. A 10-question multiple-choice test was performed just before (pre-test) and after (posttest) both sessions. Learner satisfaction was studied by adding a 6-question questionnaire to the post-test, with a 7 th additional question applied to the lecture group after they attended a compensatory simulation session one week later. Satisfaction score was obtained through a five point Likert scale. For statistical analysis the “one-way” ANOVA tests was used setting significance at p⬍0.05. Simulation group post-test mean was significantly higher than in the lecture group: 7.21 versus 5.83 (p⫽0.03). Mean score progression between tests was also higher in the simulation group, but the difference did not reach statistical significance: 3.14 versus 2.33 (p⫽0.28). There was no difference between groups in learner satisfaction (4.16 versus 4.09, p⫽0.61). However, the lecture group, when questioned after their compensatory simulation session, considered simulation to be a much more useful tool (mean score was 4.6). We concluded that this study suggests better reinforcement of knowledge in simulatorbased sessions as compared to image-based lectures, for post-graduate training of normal delivery and shoulder dystocia management. A higher study sample size is needed to confirm this result. Oral Presentation # 2 Does simulation training improve communication with a simulated patient during an obstetric emergency? Chris Bartlett, Denise Ellis, Jo Crofts, Mark James The SaFE Study Obstetric emergencies differ from anaesthetic emergencies; during most obstetric emergencies the patient is not anaesthetised. Simulation is increasingly used for obstetric training; however it is difficult to include communication with the patient using human patient simulators (HPS). METHOD: 140 staff from 6 hospitals were randomized into 24 teams. Teams underwent one of four obstetric training courses; a one day clinical course in local hospitals or at a simulation centre, or a two day clinical and teamwork course in local hospitals or at a simulation centre. Training at the simulation centre used HPSs; training locally used patient-actors. Teams were evaluated pre and post-training managing an eclampsia and PPH drill. The team’s communication with the patient was evaluated by the patient-actor during the drill using a 5-point Likert scale. Results Communication Score [Median(mean)Range] Pre-Training (nⴝ23) Post-Training (nⴝ24) Eclampsia 4 (3.8) 2–5 5 (4.5) 2–5 P⫽0.005 PPH 4 (3.5) 1–5 4 (4.2) 2–5 P⫽0.005 Communication with the patient improved following training. However, during PPH communication was significantly better following training with a patient-actor compared to training with a HPS (Mann-WhitneyU P⫽0.035); with a trend to improvement in eclampsia (P⫽0.071). Teamwork training did not affect communication (PPH: P⫽0.686, eclampsia: P⫽0.626). CONCLUSION: Simulation training can improve the patient-actor’s perception of communication during obstetric emergencies. Communication with the patient was better following training with a patient-actor than training with a HPS. Using a patient-actor can offer additional benefits in communication training. Integration of patient-actors and mannequins may be useful in obstetric simulation training. Abstracts Vol. 1, No. 3, Fall 2006 191