Reducing trainee mistakes in postpartum hemorrhage – is there better performance with changing to a high-fidelity simulation system? A randomized single blinded pilot study between high and low-fidelity models using objective structured assessment of techniques and skills

Objective We performed a prospective pilot study primarily to identify and compare trainee performance mistakes made during simulation training between high- and low-fidelity simulation models. Our secondary outcome was to assess possible improvement in repeat performance with high-fidelity training, as assessed by an objective structured assessment of training and skills (OSATS) protocol.

Materials and methods We performed a prospective randomized, single-blinded, single institution trial in a population of 17 junior obstetric trainees at the Charité University Hospital Obstetric Simulation Center in Berlin. Trainees were randomized into 2 groups with either initial low-fidelity simulation training or high-fidelity simulation followed by repeat assessment of performance using the high-fidelity model simulation system. Individual simulation sessions were video recorded, transcribed and timing of interventions documented. Standardized Objective Structured Assessment of Technique and Skills (OSATS) forms were used as a checklist for performance ([Abb. 1]).

Results We found no statistically significant difference in the initial cycle of general performance or frequency of mistakes between the initial high- and low-fidelity setups. There was however a statistically significant general improvement in performance (p=0.02 (24.7 to 27.2 of 31 points; of average 8.7%) in the second cycle of training and a statistically significant training effect (p=0.043 (24.4 to 28.4 of 31; of average 12.9%)) in the group who underwent repeat training from the initial low-fidelity to the high-fidelity system compared to the group using the same high-fidelity set up (p=0.276 (25 to 25.8 of 31, average of 2.4%)).

Abb. 1  

Conclusion Simulation training can help identify mistakes and learning gaps that are important for obstetric trainees and important to avoid in the real life emergency situation. We found that trainees make the same mistakes regardless of which simulation model was initially used. Importantly, however there was an improvement in the performance when trainees underwent a repeat cycle of training changing from a low-fidelity to a high-fidelity system. Our findings can help address the shortcomings in trainee simulation training and potentially reduce errors in obstetric emergency management.

 

MissingLinkText

Publication History

Article published online:
15 November 2023