Self-assessment and Modulation of Traction During Shoulder Dystocia Simulation Training

Area of Science:

• Obstetrics and Gynecology
• Medical Simulation
• Clinical Training

Background:

• Shoulder dystocia is a critical obstetric emergency.
• Accurate diagnosis and management are crucial to prevent neonatal injury.
• Current diagnostic methods rely on subjective assessment, potentially leading to excessive force application.

Purpose of the Study:

• To determine the diagnostic traction force for shoulder dystocia.
• To assess if applied traction can be modified through force training.

Main Methods:

• A force-measuring fetal mannequin was used in a simulated pelvis.
• Participants applied traction to diagnose shoulder dystocia, with force recorded.
• Training involved real-time force feedback, followed by blinded traction assessments.

Main Results:

• Diagnostic traction varied widely among participants.
• 22% of participants applied traction exceeding injury thresholds.
• Force training improved self-assessment accuracy and reduced excessive traction.

Conclusions:

• Subjective diagnosis of shoulder dystocia is inconsistent and can exceed safe limits.
• Force training enhances the accuracy of applied traction during simulated shoulder dystocia.
• Improved traction management can decrease the incidence of brachial plexus injury.