Shoulder dystocia simulation program: evaluation of learning from practical obstetric multi-professional training and its impact on patient outcomes

ABSTRACT

Objective. Shoulder dystocia is one of the major leading cause of both maternal and neonatal morbidity and mortality. Simulation teaching has largely become a part of the training.
Materials and Methods. A questionnaire was administered to maternity staff who had attended a simulator training course. Participants were midwives, gynecologists, and residents. We used the four levels Kirkpatrick’s Evaluation. The efficacy by participants’ responses to three specific questions.
Results. 178 questionnaires were completed. An experience of shoulder dystocia before occurred to 87% specialists in obstetrics and gynecology, 82% midwives, and 56% residents. Within six months, 26 specialists, 20 midwives and 5 residents experienced a case of shoulder dystocia. From the exploratory analysis, it was found that 43 specialists encountered shoulder dystocia both before and after attending the course. The training course on solving shoulder dystocia demonstrated significant effectiveness (X² 7.9354, p=0.004848). The model in the R environment suggests that training did not significantly enhance skills or confidence in managing shoulder dystocia, indicating the training course effective.
Conclusions. Shoulder dystocia is an unpredictable and unpreventable obstetric emergency with serious consequences. It is therefore mandatory for obstetricians and labor ward staff to be skilled in managing rare and potentially fatal emergencies. The present study, albeit based on individual training formation, involved different labor ward professionals such as obstetricians, residents, and midwives. The training course has proven to be effective, particularly for those without prior experience with shoulder dystocia. A national-wide program, represents a known way to improve outcomes in shoulder dystocia.