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A Pilot Study of Breech Extraction Simulation to Develop Confidence in Practice

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,

General Information

Oral Abstract
2016 C & A Annual
Patient Care,Medical Knowledge,
Assessment,Virtual Patient,Simulation,
Clinical Focus
Maternal-Fetal Medicine,General Ob-Gyn,

Author Information

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

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