Background: The ACOG Simulations Consortium seeks to provide a simulation based adjunct to education to help improve residency performance in certain skills, such as postpartum hemorrhage or eclampsia. Breech extraction of a second twin has not been part of this curriculum. As breech extraction remains an important skill in managing twin pregnancies, we propose a simulation based curriculum to help provide training and confidence in performing this procedure.
Methods: We developed a curriculum regarding intrapartum management of a twin pregnancy and breech extraction technique. A breech extraction simulation model was prepared. Following a lecture, the residents and faculty were first assessed regarding their clinical experience and comfort performing breech extractions. They then participated in the simulation performing a breech extraction. Following the exercise, they were reassessed regarding the an assessment of the model and confidence performing the procedure.
Results: A total of 11 providers participated in the exercise and completed surveys, including 3 interns, 5 PGY-2s, a PGY-3, a PGY-4, and an OB/GYN generalist. 7/11 participants (63%), felt their confidence in performing breech extractions improved after the simulation. All participants (11/11) felt the activity was a useful addition to residency education.
Discussions: Breech extraction is an important skill for obstetric providers in the management of twin gestation pregnancies. Simulation may play a potential role in developing confidence and skill in the procedure, and may become a useful addition to the Simulations Consortium.
Keywords: simulation, breech extraction
Topics: CREOG & APGO Annual Meeting, 2016, Resident, Faculty, Patient Care, Medical Knowledge, GME, Assessment, Virtual Patient, Simulation, Maternal-Fetal Medicine, General Ob-Gyn,
Orlando Valle, MD, Johns Hopkins School of Medicine; Christopher DeStephano, MD, MPH; Clark Johnson, MD, MPH; Linda Szymanski, MD, PhD; Jessica Bienstock, MD, MPH; Andrew Satin, MD