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Simulation to improve trainee knowledge and management of maternal cardiac arrest

Purpose: To evaluate whether a simulation-based training program improves resident knowledge and comfort in the diagnosis and treatment of maternal cardiac arrest (MCA).


Background: With maternal mortality increasing, obstetricians must be prepared to respond to MCA. Simulation-based education during residency may provide hands-on training in preparation for this rare event.


Methods: We conducted a two-hour training for Ob/Gyn residents at an academic medical center, consisting of a didactic, defibrillator skills station, and two high-fidelity simulations. Consenting residents completed a 6-item pre-test followed by a 9-item post-test exploring knowledge of and exposure to MCA. McNemar’s and paired t-tests were used to compare pre- and post-test data.


Results: Of 12 residents, 5 (42%) had no prior education about MCA and 8 (67%) never responded to a maternal code. Participants demonstrated increased knowledge about MCA after the session, providing more correct answers on the reversible causes of pulseless electrical activity arrest (4 vs 6, p< 0.001). Residents were more likely to identify the correct gestational age to perform a cesarean delivery during MCA (25% vs 92%, p< 0.01) and the correct location for this procedure (42% vs 92%, p=0.03) after the training. All residents reported that MCA training was important and that they would benefit from additional sessions. Mean composite comfort level with managing MCA significantly increased after participation (25.0 vs 37.8, p< 0.001).


Discussions: Residents report limited exposure to MCA and desire more training. Simulation-based training about MCA is needed during residency to ensure graduates are prepared to respond to this high-acuity event.

Topics: CREOG & APGO Annual Meeting, 2022, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, CME, Simulation, Lecture, Team-Based Learning, Maternal-Fetal Medicine, General Ob-Gyn,

General Information

Student,Resident,Faculty,Clerkship Director,Clerkship Coordinator,Osteopathic Faculty,Residency Director,Residency Coordinator,
Patient Care,Medical Knowledge,Interpersonal & Communication Skills,Practice-Based Learning & Improvement,
Simulation,Lecture,Team-Based Learning,
Clinical Focus
Maternal-Fetal Medicine,General Ob-Gyn,

Author Information

Stephanie Alimena, MD, Brigham and Women\'s Hospital; Taylor S. Freret, MD, EdM; Chih King, MD, PhD; Sarah C. Lassey, MD; Katherine E. Economy, MD, MPH; Sarah Rae Easter, MD

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