TY - JOUR
T1 - Using simulation training to improve shoulder dystocia documentation
AU - Goffman, Dena
AU - Heo, Hye
AU - Chazotte, Cynthia
AU - Merkatz, Irwin R.
AU - Bernstein, Peter S.
PY - 2008/12
Y1 - 2008/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=58849128328&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58849128328&partnerID=8YFLogxK
U2 - 10.1097/AOG.0b013e31818c177b
DO - 10.1097/AOG.0b013e31818c177b
M3 - Article
C2 - 19037037
AN - SCOPUS:58849128328
SN - 0029-7844
VL - 112
SP - 1284
EP - 1287
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 6
ER -