October 31, 2012By Lance Baily

HealthStream reminds us "Simulation-based Training Enhances Obstetrics Education"

(Reposted from HealthStream’s blog)

A Medical Simulation-Based Training Success Story for Allina Hospitals & Clinics, Minnesota & Wisconsin, U.S.


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Both mother and baby can experience significant harm if they experience Shoulder Dystocia (SD), a serious obstetric emergency. Injuries of this sort are among the leading causes for hospitals to be involved in obstetric litigation cases in the United States. Among Minesota- and Wisconsin-based Allina Hospitals & Clinics, a simulation customer of HealthStream partner Laerdal Medical, SD occurred between under 3% of the time, which left obstetric clinical professionals feeling inadequately prepared for this emergency event. The obstetric management staff introduced simulation training so that clinicians could practice their learned skills, experience the condition, and make mistakes in its treatment safely.

Positive feedback During Simulation Training Helps Clinicians Get it “Right”


birthing simulatorHands-On Simulation Training supplemented films and literature review and discussion for each training class. Physicians and nurses, who understood their roles and how they should act in this sort of an emergency, communicates and performed the same as if this were a actual patient  situation. During the ‘hands-on’ training, the PROMPT Birthing Simulator from Laerdal Medical was set up in a delivery room. In a hybrid simulation environment, a nurse acted as the delivering mother, sitting in the bed behind the simulator and enhancing the experience of a live clinical environment. As the simulation progressed, the acting “mother” positioned the infant in the birth canal and the simulator measured how the strength with which physicians worked to extract the baby as delivery occurred. Different maneuvers and techniques were used by individual clinicians, including breech, vacuum, forceps, normal delivery, and SD.

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Simulation-Based Training Improves Quality & Speed of Response to SD & Other Birthing Complexities

Adverse events occurred with much less frequency during the simulated delivery and in actual practice thereafter:

  • 10.5% of all SD babies  had an APGAR score less than 7 at 5 min. in 2007. Only 1.2% were scored below 7 in 2009.
  • Maternal hemorrhage subsequent to SD delivery fell from 10% to 6.7%
  • brachial plexus injuries and uterine ruptures were diminished
  • At least one facility measured a decrease in the amount of time that occurred between identification of SD and delivery

Physicians gave high marks to the simulation-based training program

Five PROMPT Simulators placed in three Allina metro hospitals as well as at the corporate offices for training use. Allina’s Pregnancy Care Council strongly recommends training participation; some hospitals make it a requirement for credentialing. Even physicians who were initially recalcitrant now have come around to an endorsement. And, all participants  said the hands-on training was particularly beneficial. Many said, “this was the best class I’ve been to in years.” “The data is dramatic,” said a hospital representative. “We’re strong believers. It has worked out very well for us.”

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