Implementation of low-cost obstetric hemorrhage simulation training models for resident education

Abstract

Introduction: Simulation is beneficial training for low frequency high acuity events such as management of obstetric hemorrhage. Our objective was to evaluate perceived competency in management of obstetric andpelvic hemorrhage following training with low fidelity task trainers using inexpensive and common medical supplies.Materials and Methods: This was a prospective observational study of training residents for management of obstetricand pelvic hemorrhage using a brief didactic instruction and low-cost task trainers with inexpensive common medicalsupplies. Participants practiced placement of a uterine tamponade balloon, uterine packing with gauze, pelvic parachutepacking and temporary abdominal closure. Following training, participants completed a self-report survey regardingperceived competency with each technique. The Wilcoxon Signed-Rank Test was used to compare results before andafter training. Results: Eighteen of 23 residents completed the training and completed the survey on perceived competencies. There was a statistically significant improvement in perceived competency for all participants before and aftertraining, with scores improving by 1.5 points for Bakri placement, from 1.94 to 3.44 (p < 0.001), improving by 1.67points for uterine packing, from 1.78 to 3.44 (p < 0.001), improving by 1.95 for pelvic parachute packing, from 1.16to 3.11 (p < 0.001), and improving by 1.89 for temporary abdominal closure, from 1.22 to 3.11 (p < 0.001).Conclusions: Low-cost supplies and task trainers can be utilized to simulate postpartum hemorrhage and improve perceived competency in managing obstetric and pelvic hemorrhage. Similar training programs can be used in small community programs with limited resources.