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Poster session I Clinical obstetrics, epidemiology, fetus, medical-surgical complications, neonatalogy, physiology/endocrinology, prematurity: Abstracts 87 - 236| Volume 208, ISSUE 1, SUPPLEMENT , S58, January 01, 2013

104: Optimization of competences in obstetrical emergencies: a place for simulation training?

      Objective

      In emergency situations inducing intense stress, optimal management requires an immediate coordinated action of the multidisciplinary and multi-professional team. This study investigates the influence of simulation training on 3 specifics skills: control of the emergency situation, knowledge of algorithms, team communication.

      Study Design

      Clinical algorithms are first presented to the participants including obstetricians and midwives. Six emergency situations (shoulder dystocia, postpartum hemorrhage, eclampsia, maternal basic life support, neonatal resuscitation, operative vaginal birth) are trained on high fidelity simulation mannequins, with subsequent debriefing. The 3 above-mentioned skills are evaluated anonymously through a self-assessment questionnaire with a five points Likert scala immediately after the training and 3 months later.

      Results

      Since 2010, 168 participants took part in the training. The return rate of questionnaires after 3 months was 36.3%. The proportion of junior doctors, specialist doctors and midwives was 31.1%, 34.7% and 34.2%. 40.2 % of the participants had less than 5 years professional experience, 23.6 % between 5 and 10 years and 36.2% more than 10 years. In comparison to the self-assessment collected directly after the course, 3 months later, the participants had emergency situations completely or rather better under control (61.5% vs. 22.8%) and the algorithms completely or rather better present (69.2% vs. 46.5%). 3 months after the training 89.7% of the participants had improved their team communication. The participants who most benefited of the training for the control of emergency situation and presence of algorithms had a professional experience between 0-5 years. The participants with a professional experience between 5-10 years improved most their team communication.

      Conclusion

      The implementation of simulation training strengthens the professional competence sustainably and contributes to optimize the peripartum care of mother and child in emergency situations.