Nitsche Joshua, Morris Dana, Shumard Kristina, Akoma Ugochi
Wake Forest School of Medicine, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Winston-Salem, North Carolina, USA.
Novant Health Forsyth Medical Center, Maya Angelou Center for Women's Health and Wellness, Winston-Salem, North Carolina, USA.
Clin Teach. 2016 Oct;13(5):343-7. doi: 10.1111/tct.12458. Epub 2015 Oct 20.
Although simulation is now used in other areas of obstetrics and gynaecology, its utility in the training of an uncomplicated vaginal delivery is surprisingly under-explored. Here we describe our experience integrating simulation into the third-year Obstetrics and Gynaecology (OB/GYN) clerkship.
In 2013/14, at the start of each 4-week OB/GYN clerkship, each third-year student participated in a 90-minute vaginal delivery simulation session using the Noelle(®) simulator. Upon completion of the clerkship, they were surveyed using a five-point Likert scale questionnaire (1, inferior; 5, superior) to assess self-perceived training adequacy, clinical preparedness and number of deliveries performed during the clerkship. Students who completed the clerkship in 2012/13, before the introduction of the simulation, were also surveyed to serve as a comparison group. Survey scores and number of deliveries performed were compared between the two cohorts of students.
The 2013/14 cohort (n = 98) who received simulation training gave their training in vaginal deliveries an average rating of 4.1, versus 2.7 for the 2012/13 cohort that did not receive the simulation (n = 80; p < 0.001). Self-perceived preparedness to perform a vaginal delivery was 4.0 in the 2013/14 cohort, versus 3.0 in the 2012/13 cohort (p < 0.001). There was no difference in the number of deliveries performed between the cohorts.
Students that received simulation rated their training adequacy and readiness to perform a vaginal delivery higher than students that did not receive training. Simulation did not increase participation in real-life deliveries. The utility of simulation in the training of an uncomplicated vaginal delivery is under-explored.
尽管模拟技术目前已应用于妇产科的其他领域，但其在无并发症阴道分娩培训中的效用却出人意料地未得到充分探索。在此，我们描述将模拟技术融入三年级妇产科实习的经验。
在2013/14学年，每4周的妇产科实习开始时，每位三年级学生使用诺埃尔（Noelle®）模拟器参加一场90分钟的阴道分娩模拟课程。实习结束后，使用五点李克特量表问卷（1分，差；5分，优）对他们进行调查，以评估自我感知的培训充分性、临床准备情况以及实习期间进行的分娩次数。在引入模拟技术之前于2012/13学年完成实习的学生也接受了调查，作为对照组。比较两组学生的调查得分和进行的分娩次数。
接受模拟培训的2013/14学年队列（n = 98）对其阴道分娩培训的平均评分为4.1分，而未接受模拟培训的2012/13学年队列（n = 80）评分为2.7分（p < 0.001）。2013/14学年队列中自我感知的进行阴道分娩的准备程度为4.0分，而2012/13学年队列为3.0分（p < 0.001）。两组队列之间进行的分娩次数没有差异。
接受模拟培训的学生对其培训充分性和进行阴道分娩的准备程度的评分高于未接受培训的学生。模拟并未增加实际分娩的参与度。模拟在无并发症阴道分娩培训中的效用尚未得到充分探索。
