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Forceps Assisted Vaginal Delivery: Bringing back a dying art with OSATS and simulation
Background: CREOG’s educational objectives list that residents are expected to understand and perform FAVD, but programs to assess and improve resident performance in FAVD are few. As such a FAVD Assessment and Educational Curriculum was developed and implemented.
Methods: A curriculum was developed that included a didactic lecture, written summaries of material for review and hands-on individual simulation sessions.
An a-priori assessment of resident knowledge and skills included a written test and an objective standardized assessment of technical skills (OSATS) in a simulation environment. After participation in the FAVD curriculum these measures were repeated. Residents were surveyed regarding their attitudes toward assisted delivery and the curriculum.
Results: 24 residents participated. Marked deficiencies in FAVD were evident in the pretest phase, most in the knowledge and skills categories. PGY year did not predict performance on the written test (p=0.58), however performance on the simulation varied by PGY year (range 35.7 – 60.0, p=0.001).
Across all PGY years, knowledge as assessed on the written test (p=0.008), knowledge & skills on the OSATS (p=0.001), overall performance (p=0.005), and economy of time and motion (p<0.001) improved after participation. Communication was rated highly in both phases and did not vary statistically. Survey data were strongly supportive of participation in the curriculum.
Conclusion: Residents demonstrate deficiencies of knowledge and skills performing FAVD. Performance and confidence improved by participating in a structured multimodal curriculum. Residents rated the simulation portion most favorably. This curriculum offers an OSATS that can be used in simulation and clinical scenarios.
Topics:
CREOG & APGO Annual Meeting, 2015, Resident, Residency Director, Patient Care, GME, Assessment, Simulation,