Development and validation of a pudendal nerve block simulation-based educational intervention

Abstract

Objective: Pudendal nerve block in modern obstetric practice is essential to providing comprehensive care. However, as clinical exposure declines, training opportunities also diminish. We aimed to develop and study an effective and reproducible simulation-based educational intervention for teaching pudendal nerve block. Methods: The pudendal nerve block simulation-based educational intervention consists of a preintervention evaluation, didactic lecture, simulation-based practice session using a task trainer, and post-intervention evaluation. The intervention was developed and refined based on pilot testing and input from experts. Multiple standardized simulation sessions were implemented at four major academic institutions. We utilized paired t-tests to compare pre- and post-simulation surveys and performance assessments, and unpaired t-tests to compare the procedural checklist data. Results: A total of 56 subjects (OBGYN residents, fellows, and attendings; family medicine residents, and attendings; and certified nurse midwives) participated in the simulation-based educational intervention. Competence, comfort, and confidence with identifying appropriate candidates, discussing benefits and risks, offering and performing, and identifying and managing complications of the procedure were higher at baseline for practicing clinicians and increased significantly after participating in the intervention for both residents and practicing clinicians (P value for all <0.001). Procedural competence as assessed by the checklist was not significantly different between residents and practicing clinicians (P value 0.96). Conclusion: A pudendal nerve block simulation-based educational intervention allows residents and practicing clinicians to develop knowledge, comfort, and confidence in identifying patient candidates, discussing risks and benefits, offering and performing the procedure, and identifying and managing resultant complications.