Akar Bertan, Ceylan Yasin, Kahraman Alper, Köle Emre, Çalışkan Eray
İstinye University Faculty of Medicine, Private Kocaeli Hospital, Clinic of Obstetrics and Gynecology, Kocaeli, Turkey.
University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2022 Jun 27;19(2):118-123. doi: 10.4274/tjod.galenos.2022.92962.
In this study, we aimed to evaluate the effects of obstetric emergencies workshops combining theoretical lectures, simulation trainers and fresh cadaver models on daily practices and referrals of obstetrics and gynecology specialists.
This is a prospective observational study involving obstetrics and gynecology specialists attending the Turkish Society of Obstetrics and Gynecology endorsed obstetrics hemorrhage management courses held in 2018 and 2019. The training course is an annually organized two-day course, one day allotted to theoretical lectures and the other day to practical training on both simulators and fresh cadavers. Trainees participating in the course was surveyed with an anonymous questionnaire on their motivation to attend the course and their juridical history of obstetric patient management. Attendees were asked to disclose whether they had ever independently performed the procedures stated in the questionnaire or not, before commencing the course and 1 year after attending the course.
Among the attendees 22% (n=32) had at least one obstetrical malpractice lawsuit and 36.1% (n=52) were accused of Health Care Complaints Comission. The main motivation of the attendees for taking this course was Professional development followed by reducing maternal mortality and morbidity and avoiding malpractice. One year after the course, attendees applying uterine devascularization surgery increased by 36.1% (52/144), uterine compression sutures increased by 52.7% (76/144), and ability to apply uterine balloon tamponade increased by 59.7% (86/144). Besides improvement in other obstetric surgical skills an indirect effect seen that the attandees operated on high-risk cases increased in placenta previa (15.3%), placenta acreata spectrum (30.5%), operative deliveries (27.7%), peripartum hysterectomy (24.9%) and relaparotomy for postpartum hemorrhage (34.7%).
Opportunities of attending well organized fresh cadaveric workshops on managing postpartum hemorrhage and other obstetric surgeries, can quickly adapt to daily practice, restore the professional confidence of obstetric and gynecology specialists, and eventually decrease patient referral.
在本研究中，我们旨在评估结合理论讲座、模拟训练器和新鲜尸体模型的产科急诊工作坊对妇产科专家日常实践和转诊的影响。
这是一项前瞻性观察性研究，涉及参加2018年和2019年由土耳其妇产科学会认可的产科出血管理课程的妇产科专家。该培训课程是每年举办一次的为期两天的课程，一天用于理论讲座，另一天用于在模拟器和新鲜尸体上进行实践培训。通过匿名问卷对参加该课程的学员进行调查，了解他们参加课程的动机以及产科患者管理的司法历史。要求参与者在课程开始前和参加课程1年后披露他们是否曾独立进行过问卷中所述的操作。
在参与者中，22%（n = 32）至少有一起产科医疗事故诉讼，36.1%（n = 52）被医疗投诉委员会指控。参与者参加本课程的主要动机是职业发展，其次是降低孕产妇死亡率和发病率以及避免医疗事故。课程结束一年后，进行子宫去血管化手术的参与者增加了36.1%（52/144），子宫压迫缝合术增加了52.7%（76/144），应用子宫球囊压迫止血的能力增加了59.7%（86/144）。除了其他产科手术技能的提高外，还观察到一个间接影响，即对前置胎盘（15.3%）、凶险性前置胎盘谱系（30.5%）、手术分娩（27.7%）、产时子宫切除术（24.9%）和产后出血再次剖腹手术（34.7%）等高风险病例进行手术的参与者增加。
参加组织良好的关于产后出血和其他产科手术管理的新鲜尸体工作坊的机会，可以使妇产科专家快速适应日常实践，恢复职业信心，并最终减少患者转诊。
