Improving Learners' Comfort With Cesarean Sections Through the Use of High-Fidelity, Low-Cost Simulation

Several studies have demonstrated effective simulation-based training for laparoscopic procedures in OB/GYN, but limited simulation curricula exist for abdominal procedures, particularly cesarean sections (CSs).

We developed a high-fidelity modification of an existing CS model costing about $25 and incorporated it into a 90-minute teaching simulation event for medical students and OB/GYN residents in a single academic program. The simulation included a structured curriculum, pre-/postsimulation surveys, a surgical instrument review, a mannequin with the CS model containing a fetus in breech position, and live video streaming. Our surveys assessed participants' comfort with the procedure and its related components on a 5-point scale, and we used a paired t test to analyze our data.

Twenty-two learners (eight third-year medical students, one fourth-year medical student, three first-year residents, four second-year residents, one third-year resident, four fourth-year residents, and one unknown level) participated in this simulation. We found a statistically significant improvement in perceived CS instrument knowledge, suturing skills, and satisfaction with the model among all participants. Only third-year medical students had a statistically significant increase in comfort level in performing a CS after the simulation. Video streaming engaged a wider audience, but poor lighting and audio limited its efficacy.

Using this simulation model at the end of medical school or early in residency may have the greatest positive effect on resident comfort with CSs. This low-cost and versatile model can be used across educational settings, including OB/GYN interest group activities, intern boot camp, and interprofessional emergency drills.