Prospective randomized trial of simulation versus didactic teaching for obstetrical emergencies

Simul Healthc. 2010 Feb;5(1):40-5. doi: 10.1097/SIH.0b013e3181b65f22.


Introduction: The objective of this study was to determine whether simulation was more effective than traditional didactic instruction to train crisis management skills to labor and delivery teams.

Methods: Participants were nurses and obstetric residents (<5 years experience). Both groups were taught management for shoulder dystocia and eclampsia. The simulation group received 3 hours of training in a simulation laboratory, the didactic group received 3 hours of lectures/video and hands-on demonstration. Subjects completed a multiple-choice questionnaire before training and before testing. After 1 month, all teams underwent performance testing as a labor and delivery drill. All drills were video recorded. Team performances were scored by a blinded reviewer using the video recordings and an expert-developed checklist. The data were analyzed using independent samples Student t test and analysis of variance (one way). P value of < or =0.05 was considered to be statistically significant.

Results: There was no statistical difference found between the groups on the pretraining and pretesting multiple-choice questionnaire scores. Performance testing performed as a labor and delivery drill showed statistically significant higher scores for the simulation-trained group for both shoulder dystocia (Sim = 11.75, Did = 6.88, P = 0.002) and eclampsia management (Sim = 13.25, Did = 11.38, P = 0.032).

Conclusions: In an academic training program, didactic and simulation-trained groups showed equal results on written test scores. Simulation-trained teams had superior performance scores when tested in a labor and delivery drill. Simulation should be used to enhance obstetrical emergency training in resident education.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Competency-Based Education / methods
  • Computer Simulation
  • Dystocia / therapy
  • Eclampsia / therapy
  • Education, Nursing, Continuing / methods
  • Female
  • Humans
  • Internship and Residency
  • Interprofessional Relations
  • Manikins*
  • Obstetric Labor Complications / therapy*
  • Obstetric Nursing / education*
  • Obstetrics / education*
  • Patient Simulation
  • Pregnancy
  • Prospective Studies