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Int J Gynaecol Obstet. 2017 Sep 23. doi: 10.1002/ijgo.12329. [Epub ahead of print]

Optimizing the amount of simulation training used to teach vaginal delivery skills to medical students.

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Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA.



To determine the amount of simulation training required for students to attain minimal competence and mastery of a vaginal delivery.


An observational study was conducted at a US medical school between May 11, 2015, and May 8, 2016. Using a modified Angoff method, 10 members of the Obstetrics and Gynecology faculty evaluated a vaginal delivery procedural checklist and established cutoff scores for minimal competence and mastery. During a 5-week period, all third-year students received between two and five 45-minute vaginal delivery simulation sessions; performance was assessed during week 6. Performance according to the checklist was compared.


The cutoff score was 20 and 26 out of 30 for minimal competence and mastery, respectively. Among 115 students, mean checklist scores in final assessment rose with increasing number of simulations: 23.6, 25.1, 27.5, and 27.6 points for two, three, four, and five training sessions, respectively (P<0.001). The proportion of patients achieving mastery also increased with number of simulations: 34%, 59%, 73%, and 93% for two, three, four, and five training sessions, respectively (P<0.001). Two or three training sessions were sufficient to attain minimal competence in most students; however, no significant between-group difference was found.


Simulation training exerts an increasing effect on performance with each additional session that students receive.


Clinical obstetrics; Labor and delivery; Medical education; Medical student; Simulation; Vaginal delivery

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