Learning From Experience: Qualitative Analysis to Develop a Cognitive Task List for Vaginal Breech Deliveries.

Area of Science:

• Obstetrics and Gynecology
• Medical Education
• Surgical Skills Training

Background:

• Clinical competence in vaginal breech delivery (VBD) is difficult to achieve due to limited trainee exposure.
• Novel educational strategies are needed to address this challenge in contemporary obstetrics.

Purpose of the Study:

• To identify the essential verbal and non-verbal skills for managing vaginal breech delivery (VBD).
• To develop an educational framework for VBD management through expert-led demonstrations.

Main Methods:

• Clinicians skilled in VBD were identified by nursing staff at three university-affiliated hospitals.
• Participating experts demonstrated VBD on a birth simulator, discussing their techniques and providing insights.
• Videos were analyzed to identify and categorize verbal and non-verbal communication and procedural skills.

Main Results:

• Twelve experienced clinicians participated, contributing to the identification of key management themes.
• Identified themes included meticulous antepartum assessment and counseling, multidisciplinary team roles, parent communication, delivery techniques, and postpartum care.
• A comprehensive clinical task list for safe VBD was generated.

Conclusions:

• A comprehensive task list for safe vaginal breech delivery (VBD) was developed based on expert experience.
• Key elements for safe VBD include rigorous patient selection, appropriate counseling, knowing when to perform a Cesarean section, and employing a "hands off" delivery approach.