[[Simulation Training for Critical Obstetric Hemorrhage in Cesarean Section for Medical Students with Human Patient Simulator (HPS®), Comparison between Role-play and Impromptu Simulation[].

BACKGROUND

The simulation training for critical obstetric hemorrhage for medical students, lacks a gold standard, but should be effectively performed. To opti- mize the simulation for critical obstetric hemorrhage with human patient simulator (HPS® Human Patient Simulator Muse2.1, CAE Healthcare, Quebec, Canada), we assessed the effectiveness of impromptu simulation and role-play simulation among fifth-year medical stu- dents.

METHODS

The role-play simulation among 49 medi- cal students, of obstetric critical hemorrhage in Cesar- ean section was compared with the learning effect of the unprepared impromptu simulation among other 49 medical students. (observational cohort study). The effects of simulation training was assessed with pre and post numbers of answers for the question "the management items for critical obstetric hemorrhage in cesarean section".

RESULTS

The items of answer pre- and post-simula- tion were, oxygen administration, uterotonic drugs, infusion, preparation of the blood products, blood sam- ple examination, cross-matching test ensuring of the manpower, plasma substitute administration, vasopres- sors, blood transfusion, intraoperative blood salvage, interventional radiology, arterial line, central venous catheter, airway management general anesthesia and total hysterectomy. Simulation provided a learning effect for these items. In impromptu simulation, the numbers of answers per one medical student were increased from 2.3 ±1.4 to 7.0±3.0 items (P<0.0001). In another role-play simulation, those were increased from 2.1±1.8 to 5.6±2.3 items (P<0.0001).

CONCLUSIONS

The impromptu simulation was con- sidered to have a superior learning effect than role-play simulation.