Improving Learners' Comfort With Cesarean Sections Through the Use of High-Fidelity, Low-Cost Simulation.

INTRODUCTION: Several studies have demonstrated effective simulation-based training for laparoscopic procedures in OB/GYN, but limited simulation curricula exist for abdominal procedures, particularly cesarean sections (CSs). METHODS: We developed a high-fidelity modification of an existing CS model costing about $25 and incorporated it into a 90-minute teaching simulation event for medical students and OB/GYN residents in a single academic program. The simulation included a structured curriculum, pre-/postsimulation surveys, a surgical instrument review, a mannequin with the CS model containing a fetus in breech position, and live video streaming. Our surveys assessed participants' comfort with the procedure and its related components on a 5-point scale, and we used a paired t test to analyze our data. RESULTS: Twenty-two learners (eight third-year medical students, one fourth-year medical student, three first-year residents, four second-year residents, one third-year resident, four fourth-year residents, and one unknown level) participated in this simulation. We found a statistically significant improvement in perceived CS instrument knowledge, suturing skills, and satisfaction with the model among all participants. Only third-year medical students had a statistically significant increase in comfort level in performing a CS after the simulation. Video streaming engaged a wider audience, but poor lighting and audio limited its efficacy. DISCUSSION: Using this simulation model at the end of medical school or early in residency may have the greatest positive effect on resident comfort with CSs. This low-cost and versatile model can be used across educational settings, including OB/GYN interest group activities, intern boot camp, and interprofessional emergency drills.

Duke Scholars

Author Sarah K. Dotters-Katz Obstetrics and Gynecology, Maternal Fetal Medicine