(229) A novel virtual simulation training improves providers’ knowledge and confidence to manage obstetric emergencies

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: Maternal mortality in the United States (US) is rising and many deaths are preventable. We sought to determine the efficacy of virtual simulation training to optimize management of obstetric emergencies within low and moderate volume delivery hospitals that are disproportionately affected by adverse maternal outcomes.

Study Design: The educational platform was designed and deployed within urban non-teaching and rural hospitals, with low and moderate delivery volumes, in the US during the COVID-19 pandemic. Self-paced, interactive, online didactics on postpartum hemorrhage and hypertensive disorders of pregnancy were followed by two, 2-hour live virtual simulation trainings and debriefings. In this innovative simulation modality, participants verbalized actions to their co-participants and the simulation faculty as scenarios evolved with images, vitals and videos displayed on a PowerPoint. Participants completed multiple-choice questionnaires and confidence and attitude surveys prior to, immediately after and 3-months post-training. The multiple-choice questions were evidence-based using information from published guidelines and were validated by local experts. Paired t-tests were performed to asses for changes in knowledge and confidence.

Results: From December 2021 to March 2022, four hospitals received training (Table 1). Participants (n=22) were comprised of nurses (59%), certified nurse midwives (14%) and attending physicians (23%) in Obstetrics, Family Practice or Anesthesiology. The survey response rate was 59%. The mean difference in knowledge and confidence scores significantly improved immediately post-training compared to baseline (P < 0.05 for all, Table 2). This improvement was maintained 3 months following the training. Participants reported their preferred training format was hybrid (43%), virtual (35.7%) or in-person (21.4%).

Conclusion: Virtual obstetric simulation is feasible and improves knowledge and confidence, which can be retained over time. This educational modality is sustainable, scalable and an accessible format to enhance education and training.

Primary & Presenting Author(s)

Kathleen C. Minor, MD (she/her/hers)
Fellow
Stanford University
Stanford, California, United States

Coauthor(s)

JM
Jonathan A. Mayo, MPH
Stanford University
Stanford, California, United States
KB
Katherine Bianco, MD
Stanford University School of Medicine
Stanford, California, United States
AJ
Amy Judy, MD
Clinical Assistant Professor
Stanford University
Stanford, California, United States
GA
Gillian Abir, MD
Stanford University
Stanford, California, United States
HL
Henry C. Lee, MD
Associate Professor Of Pediatrics (Neonatology)
Stanford University
Stanford, California, United States
Stephanie A. Leonard, PhD (she/her/hers)
Assistant Professor
Stanford University
Stanford, California, United States
LS
Lillian Sie, MPH
Stanford University
Stanford, California, United States
SA
Stephany Ayotte, RN
Stanford University
Stanford, California, United States
Kay I. Daniels, MD
Clinical Professor Obstetrics and Gynecology CoDirector of Disaster Planning for the Johnson Center for Pregnancy and Newborn Services
Stanford University School of Medicine
Stanford, California, United States