Using simulation training to improve shoulder dystocia documentation

Dena Goffman, Hye Heo, Cynthia Chazotte, Irwin R. Merkatz, Peter S. Bernstein

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

OBJECTIVE:: To estimate whether shoulder dystocia documentation could be improved with a simulation-based educational experience. METHODS:: Obstetricians at our institution (n=71) participated in an unanticipated simulated shoulder dystocia followed by an educational debriefing session. A second shoulder dystocia simulation was completed at a later date. Delivery notes were a required component of each simulation. Notes were evaluated using a standardized checklist for 16 key components. One point was awarded for each element present. Wilcoxon signed rank tests were used to compare documentation between simulations. RESULTS:: Participants consisted of 43 (61%) attending and 28 (39%) resident physicians. Ages ranged from 25-63 years (mean±standard deviation 37.0±9.0), and 75% were female. Years of obstetric experience for our attendings ranged from 4 to 31 years (14.5±8.1). Documentation scores were significantly improved after training. Attendings' baseline documentation scores were 8.5±2.2 and improved to 9.4±2.3, P=.03. Residents' documentation scores also improved (9.0±2.1 compared with 10.6±2.2, P=.001). In particular, improvement was seen in two components of documentation: 1) providers present for shoulder dystocia (P=.007) and 2) which shoulder was anterior (P<.001). No improvement was seen in standard delivery note components (eg, date, time) or infant characteristics (eg, weight, Apgar scores). CONCLUSION:: Although we showed a significant improvement in the quality of documentation through this simulation program, notes were still suboptimal. Use of standardized forms for shoulder dystocia delivery notes may provide the best solution to ensure appropriate documentation.

Original languageEnglish (US)
Pages (from-to)1284-1287
Number of pages4
JournalObstetrics and Gynecology
Volume112
Issue number6
DOIs
StatePublished - Dec 2008

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Dystocia
Documentation
Apgar Score
Simulation Training
Nonparametric Statistics
Quality Improvement
Checklist
Obstetrics
Physicians
Weights and Measures

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Using simulation training to improve shoulder dystocia documentation. / Goffman, Dena; Heo, Hye; Chazotte, Cynthia; Merkatz, Irwin R.; Bernstein, Peter S.

In: Obstetrics and Gynecology, Vol. 112, No. 6, 12.2008, p. 1284-1287.

Research output: Contribution to journalArticle

Goffman, Dena ; Heo, Hye ; Chazotte, Cynthia ; Merkatz, Irwin R. ; Bernstein, Peter S. / Using simulation training to improve shoulder dystocia documentation. In: Obstetrics and Gynecology. 2008 ; Vol. 112, No. 6. pp. 1284-1287.
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