Simulation training and resident performance of singleton vaginal breech delivery

Obstet Gynecol. 2006 Jan;107(1):86-9. doi: 10.1097/01.AOG.0000192168.48738.77.


Objective: To determine whether simulation training improves resident competency in the management of a simulated vaginal breech delivery.

Methods: Without advance notice or training, residents from 2 obstetrics and gynecology residency programs participated in a standardized simulation scenario of management of an imminent term vaginal breech delivery. The scenario used an obstetric birth simulator and human actors, with the encounters digitally recorded. Residents then received a training session with the simulator on the proper techniques for vaginal breech delivery. Two weeks later they were retested using a similar simulation scenario. A physician, blinded to training status, graded the residents' performance using a standardized evaluation sheet. Statistical analysis included the Wilcoxon signed rank test, McNemar chi2, regression analysis, and paired t test as appropriate with a P value of less than .05 considered significant.

Results: Twenty residents from 2 institutions completed all parts of the study protocol. Trained residents had significantly higher scores in 8 of 12 critical delivery components (P < .05). Overall performance of the delivery and safety in performing the delivery also improved significantly (P = .001 for both).

Conclusion: Simulation training improved resident performance in the management of a simulated vaginal breech delivery. Performance of a term breech vaginal delivery is well suited for simulation training, because it is uncommon and inevitable, and improper technique may result in significant injury.

Level of evidence: II-2.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Breech Presentation*
  • Clinical Competence*
  • Delivery, Obstetric / education*
  • Delivery, Obstetric / methods
  • Education, Medical, Graduate
  • Female
  • Humans
  • Internship and Residency
  • Male
  • Obstetrics / education
  • Patient Simulation
  • Pregnancy