Evaluation of a shoulder dystocia training model

Abstract

Shoulder dystocia is unpredictable and can result in unacceptably high morbidity. Currently there are no high fidelity training models available and this project evaluates a realistic mannequin which can be used to train midwives and doctors to correctly manage shoulder dystocia so as to reduce morbidity. Thirty-eight midwives and obstetricians in two South West hospitals were evaluated using the high fidelity training mannequin we developed. Practical skills required to deliver the baby were assessed using a validated checklist which assessed the timing and the execution of the manoeuvres. Force data were collected using a real-time force monitoring system, anatomically designed to simulate brachial plexus forces. There was a statistically significant increase in the total scores obtained by both groups after training (P-values <0.003). The data on force were obtained from only 10 participants, but still showed clinically significant findings. Peak traction forces ranged from 7 N to 379 N (95% CI of −2.3–163.9 N) before training, and 14 to 81 N (95% CI of 29.0–64.9 N) after training. Time to delivery also tended to be shorter (95% CI of 120.3–222.9 seconds before training and 88.0–154.4 seconds after training).