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Novel Uterine Model Improves Resident Confidence in Intrapartum Management of Postpartum Hemorrhage
Purpose: To pilot an inexpensive, compressible uterine model to teach intrapartum management of postpartum hemorrhage (PPH).
Background: Surgical management of PPH is a required milestone, however, low clinical volume may impact a resident’s ability and confidence to perform certain procedures. Our goal was to create a reusable, compressible uterine model to supplement the ACOG simulation for intraoperative management of PPH when teaching O’Leary and B-Lynch sutures.
Methods: Our model was created by shaping a foam cushion into a hollow uterus, filling the apex with cotton batting and covering it with red felt. Thick red and blue yarn were added to simulate uterine vessels prior to covering the model with press-n-seal. The model was used during our scheduled simulation for PPH management. Along with the ACOG quiz, residents reported their confidence in 1) identifying and managing PPH, and 2) performing O’Leary and B-Lynch sutures pre- and post-simulation.
Results: Six models were created for $6.94 each. All PGY level residents (n=14) successfully performed O’Leary and B-Lynch sutures. Only two residents had performed these pre-simulation. Resident confidence improved significantly post-simulation for 1) identifying (3.1 vs 4.0/5, p=0.00) and managing PPH (3.1 vs 3.9/5, p=0.00), and 2) performing O’Leary (1.6 vs 2.9/5, p=0.00) and B-Lynch (1.7 vs 3.1/5, p=0.00). Residents stated the model performed similarly to uterine tissue (mean 3.1/5) and improved their ability to manage PPH (mean 4.5/5). The model also allowed placement of a Bakri balloon.
Discussions: Our compressible, inexpensive and reusable uterine model improved resident confidence in performing surgical PPH management. Continued simulation may further strengthen resident confidence.
Topics:
CREOG & APGO Annual Meeting, 2021, Resident, Faculty, Residency Director, Patient Care, GME, Simulation, General Ob-Gyn,
