Virtual Obstetric Emergency Simulations: Enhancing Knowledge, Skills, and Confidence of Emergency Medicine and Obstetric Professionals

Jennifer Mitzman; Sheryl A. Pfeil; Saurabh Rahurkar; Pallavi Jonnalagadda; Lindsey Sova; Megan E. Gregory; Nicole McGarity; James Read; Allison Stevens; Rashelle Ghanem; Scott Winfield; Cynthia S. Shellhaas

doi:10.1055/a-2419-8810

American Journal of Perinatology, Table of Contents

Am J Perinatol 2025; 42(06): 773-780
DOI: 10.1055/a-2419-8810

Original Article

Virtual Obstetric Emergency Simulations: Enhancing Knowledge, Skills, and Confidence of Emergency Medicine and Obstetric Professionals

Jennifer Mitzman

¹Departments of Emergency Medicine and Pediatrics, The Ohio State University, Columbus, Ohio

,

Sheryl A. Pfeil

²Department of Internal Medicine, The Ohio State University, Columbus, Ohio

,

Saurabh Rahurkar

³The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), The Ohio State University, Columbus, Ohio

,

Pallavi Jonnalagadda

³The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), The Ohio State University, Columbus, Ohio

,

Lindsey Sova

⁴Clinical Skills Education and Assessment Center (CSEAC), The Ohio State University, Columbus, Ohio

,

Megan E. Gregory

⁵Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida

,

Nicole McGarity

⁶Department of Emergency Medicine, The Ohio State University, Columbus, Ohio

,

James Read

⁷Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania

,

Allison Stevens

⁴Clinical Skills Education and Assessment Center (CSEAC), The Ohio State University, Columbus, Ohio

,

Rashelle Ghanem

⁸Department of Children and Youth, Ohio Department of Health, Columbus, Ohio

,

Scott Winfield

⁴Clinical Skills Education and Assessment Center (CSEAC), The Ohio State University, Columbus, Ohio

,

Cynthia S. Shellhaas

⁹Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio

› Author Affiliations

Abstract

Objective

Between 2008 and 2016, 23% of pregnancy-related deaths in Ohio occurred in an emergency department (ED) or outpatient setting. Prior research showed that 98% of Ohio's delivery hospitals conduct obstetric (OB) emergency simulations, whereas only 30% include ED staff. The goal of the grant was to increase the knowledge, skill, and self-efficacy of emergency medicine (EM) professionals in managing OB emergencies. In addition to EM professionals, there was high interest by obstetrics and gynecology (OB/GYN) and other professionals in the course. Therefore, the goal of the project was to increase these elements for all professionals including EM and non-EM professionals in managing OB emergencies.

Study Design

Twelve virtual training courses using simulated patient encounters and video-based skills training were conducted across Ohio on the management of OB emergencies. Scenarios focused on common causes of pregnancy-related death using data from the Ohio Pregnancy-Associated Mortality Review Committee. Pre- and posttests assessed training effectiveness.

Results

Between August 1, 2020, and June 30, 2023, 258 learners completed the course. Most were female (76.76%), White (90.61%), and under 45 years old (69.40%). Most (66.49%) were from EM, followed by OB/GYN (18.09%), and other specialties (15.43%) including family medicine and pediatric EM. Most worked in hospital settings (89.19%). Learners reported a median 10.00 (interquartile range [IQR]: 15.00) years in clinical practice. Overall, mean knowledge scores increased by 0.81 (95% confidence interval [CI]: 0.62, 1.01), after the course (p < 0.001). Mean knowledge scores increased by 0.90 (95% CI: 0.64, 1.16; p < 0.001), 0.67 (95% CI: 0.24, 1.09; p = 0.003), and 0.60 (95% CI: 0.16, 1.04; p = 0.01) for those from EM, OB/GYN, and other specialties, respectively. Median scores for reported self-efficacy increased by 24.00 (IQR: 22.33) and self-reported skills increased by 30.42 (IQR: 22.83) points (p < 0.001).

Conclusion

Virtual simulations can be effective in improving EM, OB, and other professionals' knowledge, self-efficacy, and self-reported skills in managing OB emergencies.

Key Points

Obstetric knowledge and skills can be taught effectively in a virtual environment.
Educational interventions can use pregnancy-associated mortality data to target local patterns.
Simulation can teach management of high-acuity, low-frequency obstetric emergencies to learners.

Keywords

obstetric - emergency - simulation - education - virtual

Full Text

References

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Supplementary Material

Supplementary Material