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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 
1   Departments of Emergency Medicine and Pediatrics, The Ohio State University, Columbus, Ohio
,
Sheryl A. Pfeil
2   Department of Internal Medicine, The Ohio State University, Columbus, Ohio
,
Saurabh Rahurkar
3   The 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
3   The 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
4   Clinical Skills Education and Assessment Center (CSEAC), The Ohio State University, Columbus, Ohio
,
Megan E. Gregory
5   Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida
,
Nicole McGarity
6   Department of Emergency Medicine, The Ohio State University, Columbus, Ohio
,
James Read
7   Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania
,
Allison Stevens
4   Clinical Skills Education and Assessment Center (CSEAC), The Ohio State University, Columbus, Ohio
,
Rashelle Ghanem
8   Department of Children and Youth, Ohio Department of Health, Columbus, Ohio
,
Scott Winfield
4   Clinical Skills Education and Assessment Center (CSEAC), The Ohio State University, Columbus, Ohio
,
Cynthia S. Shellhaas
9   Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
› Author Affiliations
Funding This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $10,361,110 with 0% percentage financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by the Ohio Department of Children and Youth, ODH, HRSA, HHS or the U.S. Government. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.
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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

Authors' Contributions

All authors meet the criteria for authorship per journal guidelines and referred to by initials based on names above. Conception and research design work was performed by J.M., S.A.P., M.E.G., N.M., J.R., A.S., R.G., and C.S. Acquisition work was performed by previously mentioned authors J.M., S.P., M.E.G., N.M., J.R., A.S., R.G., C.S., and S.W. Analysis work was performed by S.R., P.J., L.S., and M.E.G. Interpretation was performed by J.M., S.A.P., S.R., P.J., L.S., A.S., R.G., and C.S.S. Primary drafting was performed by J.M., S.P., S.R., P.J., L.S., A.S., R.G., S.W., and C.S.S. All authors performed critical review and issued final approval for publication. All authors agree to be accountable for all aspects of the work related to accuracy and integrity and to resolve any questions related to same.


Supplementary Material



Publication History

Received: 22 February 2024

Accepted: 20 September 2024

Accepted Manuscript online:
24 September 2024

Article published online:
16 October 2024

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