The World Health Organization estimates that approximately 830 women die from preventable causes related to pregnancy and childbirth every day, with most of these deaths occurring in low-resource settings. Simulation in obstetrics can help to address this issue by providing healthcare professionals with the necessary training and skills to manage complicated births and reduce adverse outcomes.

As a result, in the last years, medical simulation became an integral part of obstetric education and training in many places around the globe and therefore plays an important role in addressing patient safety problems in this high-risk field of medicine. One major patient safety concern in obstetrics is the risk of medical errors. Obstetric emergencies can be complex and require rapid decision-making, often under stressful conditions. Medical errors can also occur due to a lack of experience, poor communication, or inadequate training. As we know, childbirth and related complications can lead to serious harm to both mothers and infants with significant morbidity and mortality rates.

As discussed before in this channel, simulation provides healthcare professionals with a safe and controlled environment in which to practice and refine their clinical skills without putting real patients at risk. Simulation – also in obstetrics – can be a valuable tool for healthcare professionals to develop the necessary knowledge, skills, and confidence to manage childbirth and related complications safely and effectively. This fact was already described in literature. For example, a systematic review of simulation-based training in obstetrics found that simulation-based training improved skills and knowledge related to emergency obstetric care (Soreide, Van der Vleuten, & Lippert, 2018).

As in other fields of healthcare, also in obstetrics, one of the most significant benefits of simulation is the ability to repeat scenarios and receive immediate feedback on performance. This iterative approach allows obstetricians, midwives and all involved specialties to practice their skills and refine their techniques until they become second nature. It also enables educators to identify areas where learners may need additional support or guidance.

Simulations can be designed to replicate a range of obstetric scenarios, from normal deliveries to complex emergency situations. This allows learners to practice their skills in a more immersive and interactive setting, which can help to build their confidence and reduce anxiety in real-world situations.

Effective teamwork is critical in obstetrics, where complex emergencies often require multiple healthcare professionals to work together to manage the situation.  Obstetric emergencies can occur unexpectedly, requiring quick and effective decision-making by healthcare professionals, which challenges the teamwork even more. We also know that these are high risk situations for making medical errors. Simulation provides opportunities for team-based learning in obstetrics. Healthcare professionals can practice working together as a team, improving communication, collaboration, and patient outcomes. In a study of interprofessional simulation-based training for obstetric emergencies it was found that it improved communication, coordination, and teamwork among healthcare professionals (Pak et al., 2019).

Another main patient safety concern also arises from a lack of standardized training and education. The quality of obstetric education and training can vary widely across different institutions and countries, leading to inconsistencies in clinical practice and patient outcomes. Simulation-based training can help to standardize obstetric education and ensure that healthcare professionals have the necessary skills and knowledge to manage childbirth and related complications effectively, regardless of their location or training background.

One of the patient safety problems in obstetrics is the management of postpartum hemorrhage. This is a common complication that can occur after childbirth and can lead to significant maternal morbidity and mortality. Its also a common scenario that is trained during Simulation-based training. That this makes a lot of sense, is shown in a study of simulation-based training for postpartum hemorrhage found that it improved the management of postpartum hemorrhage and reduced the incidence of severe postpartum hemorrhage (Chen et al., 2019).

Another dangerous complication in obstetrics is shoulder dystocia, which occurs when the baby’s shoulders become stuck during delivery. This can lead to brachial plexus injuries or even death of the newborn if not managed correctly and even in high risk for morbidity for the mother. It was also able to show in a study of simulation-based training for shoulder dystocia found that simulation-based training improved the confidence and performance of healthcare professionals in managing this obstetric emergency (Graham et al., 2017).

All in all, simulation in obstetrics is a valuable tool for addressing patient safety problems in this high-risk field of medicine. By providing a safe and effective learning environment for healthcare professionals to practice and refine their skills, simulation can help to reduce medical errors and improve patient outcomes. By improving the quality of education and training, simulation can ultimately help to improve the safety of obstetric care and reduce maternal and neonatal morbidity and mortality.

Written by Lukas Drabauer from Alpha Medical Concepts (AMC)

References:

Soreide, E., Van der Vleuten, C., & Lippert, A. (2018). Simulation-based training in obstetrics and gynecology: a systematic review. Acta Obstetricia et Gynecologica Scandinavica, 97(10), 1178-1187.

Chen, X., Yan, X., Song, C., Dong, X., Tang, Y., Chen, X., & Qi, H. (2019). Simulation-based training for postpartum hemorrhage: a randomized controlled trial. BMC Pregnancy and Childbirth, 19(1), 208.

Graham, E. M., Ostroff, R., Bhimani, S., Antoniou, A., Miller, A., & Wetmore, M. (2017). A randomized controlled trial of shoulder dystocia simulation training. American Journal of Obstetrics and Gynecology, 216(4), 400.e1-400.e7.

Pak, S., Dixon-Woods, M., Darzi, A., & Vincent, C. (2019). The use of simulation in obstetrics: a descriptive review of the literature. BJOG: An International Journal of Obstetrics and Gynaecology, 126(1), 52-63.