Improving Comfort in Obstetric Skills of Emergency Medicine Residents With Lecture- and Simulation-Based Training

Objectives The study aimed to determine whether obstetrician-led lecture- and simulation-based training improves Emergency Medicine (EM) residents' comfort in managing complicated obstetric conditions. Methods Residents from Mercy St. Vincent Medical Center Emergency Medicine residency program in Toledo, Ohio participated in the study. Four clinical scenarios were chosen: shoulder dystocia, breech vaginal delivery, severe hypertensive disorder of pregnancy, and resuscitative hysterotomy. Participants attended a two-hour lecture series and subsequent simulation training with live-action situations for each chosen clinical scenario. Participants completed pre- and post-training surveys, which assessed comfort in performing the selected obstetric practices using the Likert Scale. Survey responses were analyzed for each item and presented by frequency count and percentage. Results Thirty-two EM residents completed a survey before the education and 25 of these residents completed a survey after the training. Before education, comfort levels performing obstetric procedures were low: three (9%) residents were comfortable knowing and performing maneuvers for shoulder dystocia, one (3%) for breech vaginal delivery, and one (3%) for resuscitative hysterotomy. Ten (31%) residents were comfortable managing severe hypertensive disorder. After education, the percentage of residents who reported being comfortable significantly increased (p<,0.05) in all clinical scenarios. Twenty-two (88%) residents strongly agreed that targeted lecture- and simulation-based training from an Obstetrician Gynecologist (OBGYN) will improve their comfort in assessing and treating complicated obstetric problems. Conclusions Obstetrician-led lecture- and simulation-based training can improve EM residents' comfort in managing complicated obstetric conditions, and a collaborative, interdepartmental approach likely optimizes success in training EM residents.