Using Simulation to Improve and Maintain Obstetrical Skills in Rural Hospitals.

Rural obstetric providers have differing educational needs, compared with those in large urban settings based on challenges faced when delivering maternal health care. There are 2 groups of rural obstetric providers, those with and without previous obstetric training, which dictates for each group, differing goals for skills improvement and maintenance. Training in rural hospitals should focus on infrequent high-risk events, constrained by systems deficiencies, all which are ideally addressed with in-situ simulation. Using a mobile simulation approach, visiting each facility with a single set of high-fidelity equipment and experts seems a cost-effective way to provide education to rural obstetric providers.