Twin vaginal delivery: To maintain skill - simulation is required.

Area of Science:

• Obstetrics and Gynecology
• Medical Simulation
• Surgical Education

Background:

• Despite recommendations for vaginal twin delivery, cesarean section rates are increasing.
• Concerns exist about the potential loss of essential obstetrical skills due to medicolegal and emotional factors.
• Rising cesarean rates for twins pose risks to maternal and infant outcomes.

Purpose of the Study:

• To develop and evaluate a realistic simulation model for second twin vaginal delivery.
• To assess the impact of simulation training on obstetrics residents' skills and confidence.
• To provide a tool to support the practice of vaginal twin delivery.

Main Methods:

• A realistic simulation model for second twin delivery was designed.
• Obstetrics residents participated in simulation training using the model.
• Performance metrics, including time for procedures and confidence scores, were assessed before and after training.

Main Results:

• Significant improvement was observed in the time required for internal podalic version and breech extraction.
• Residents demonstrated a significant increase in confidence scores after simulation training.
• The simulation effectively enhanced technical skills for managing second twin deliveries.

Conclusions:

• The developed simulation device effectively improves obstetrical skills for second twin delivery.
• This simulation can contribute to the increased adoption of vaginal twin delivery.
• The model aligns with simulation-based medical education principles and can combat rising cesarean rates for twins.