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
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