Presenting Author:

Devon Langston, B.A.

Principal Investigator:

Magdy Milad, M.D.

Department:

Obstetrics and Gynecology

Keywords:

Global Health, Simulation, Non-Obstetric Residents

Location:

Third Floor, Feinberg Pavilion, Northwestern Memorial Hospital

E20 - Education Women's Health Research

Global Health Preparation: Implementing Obstetrics & Gynecology Simulation for Non-Subspecialist

Background: Many specialists outside of Obstetrics and Gynecology spend considerable time in other countries providing women’s health care. The aim of this prospective study was to evaluate a low-tech, low-cost, team-based obstetrics and gynecology simulation session designed for non-obstetrical residents preparing for a global health rotation. This simulation session focused on optimizing their skills in caring for women and improving their confidence levels surrounding routine OB/GYN care. Methods: Didactic and experiential training was developed by Obstetrics and Gynecology faculty specifically for non-obstetrical residents preparing for a global health rotation. The course sought to develop understanding of six common obstetric and gynecologic conditions and recognition of emergencies that could be managed by non-obstetric trainees. Participants completed a pre- and post-test self-assessment utilizing a 4-point Likert Scale. The results were compared to evaluate the effectiveness of training and self-reported confidence in performing the skills. Results: The one day curriculum included didactic instruction and hands-on training. Sixteen (16) non-obstetric resident physicians from five specialty areas participated in the training. All resident physicians spent 30 minutes at each of the six stations while mentored by OB/GYN attending and resident physicians. Costs associated with the curriculum were estimated to be $30/trainee excluding faculty time. All participants considered training either helpful (45%) or very helpful (55%). At the completion of the session, most trainees felt very comfortable (top quartile of the Likert scale) performing vaginal deliveries (76.9%), assessing cervical dilation (84.6%) and estimating blood loss/postpartum hemorrhage (69.2%). Only 46 percent of the participants surveyed felt very confident repairing vaginal lacerations. Conclusions: Low cost simulation for non-obstetric resident trainees anticipating a global health experience is feasible and easily implemented. Participants felt very comfortable assessing cervical dilation, performing vaginal deliveries and assessing postpartum hemorrhage. Targeting procedures and maneuvers that are considered high yield and technically less complex would help improve trainee comfort, particularly in the areas of laceration repair.