Impact of a regional simulation-based training course in the implementation of external cephalic version:...

Area of Science:

• Obstetrics and Gynecology
• Medical Education
• Surgical Simulation

Background:

• External cephalic version (ECV) is a procedure to manually turn a fetus from a breech to a cephalic presentation.
• Limited adoption and variable success rates of ECV highlight the need for effective training strategies.
• Simulation-based training offers a controlled environment to enhance procedural skills.

Purpose of the Study:

• To evaluate the impact of a regional simulation-based training course on ECV adoption and success rates.
• To determine if the training increased ECV implementation in hospitals previously not performing it.
• To assess if the training improved ECV success rates in hospitals already offering the procedure.

Main Methods:

• An intervention study involving 10 Portuguese public maternity hospitals.
• Two obstetrics and gynecology specialists from each hospital attended a structured simulation-based ECV training.
• Hospitals were categorized by prior ECV practice and annual delivery volume; outcomes included ECV numbers and success rates pre- and post-training.

Main Results:

• ECV implementation was initiated in four additional hospitals within two years post-training.
• No significant difference in ECV success rates was observed in the three hospitals already performing the procedure (45.6% vs. 47.9%).
• Successful ECV resulted in a vaginal delivery for 77.7% of women.

Conclusions:

• Regional simulation-based ECV training successfully increased the number of hospitals adopting the technique.
• The training did not significantly affect success rates in centers with established ECV practice.
• Simulation-based courses show promise for ECV training, emphasizing the need for improved patient access and regional service centralization.