Improving Learners' Comfort With Cesarean Sections Through the Use of High-Fidelity, Low-Cost Simulation

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study

BACKGROUND

Simulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives' competency in Ethiopia.

METHODS

A quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020.

RESULT

The age of the respondents varies from 24 to 34 years, with the control group's mean age being 28.8 (± 2.3) years and the intervention group's mean age being 27.2 (± 2.01) years. The intervention and control groups' pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these.

CONCLUSIONS

The study showed that simulation-based education improved students' procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.

Full-Dress Rehearsals with Actual Non-Infected Patients Builds Confidence and Familiarity - An Experience from Singapore during the COVID-19 Pandemic

PURPOSE

COVID-19 has spread throughout the world with merciless pace. Personal protective equipment (PPE) is required to protect healthcare workers from contracting the virus. The authors evaluated the use of full-dress rehearsals (FDR) to familiarize staff with protocols and equipment that are not often use otherwise.

METHODS

A single institution in Singapore performed FDR with noninfected patients for endoscopy after refresher courses with PPE were conducted. FDRs were conducted between February and March 2020, during the initial phase of the COVID-19 outbreak. The FDRs involved all phases of endoscopy. Statistics from the FDRs were compared against baseline procedure statistics. A self-administered survey was conducted for the procedurists after the FDRs.

RESULTS

A total of 26 FDRs were conducted and 20 (77%) completed the survey. Among all the FDRs conducted, there was a slight increase in duration for colonoscopy FDRs (21.5 min vs 20.0 min, p = 0.22). There were no complications. All respondents had a good experience (score rating of 4-5/5).On qualitative analysis, the themes identified were:FDRs provided a good opportunity to have hands-on familiarization of the equipment on top of routine refresher training.Participants were cognizant of the ongoing outbreak and the evolving threat.Safety measures were reinforced.Procedurists who acknowledged weaknesses, requested for more training.

CONCLUSIONS

Simulation training with patients provides participants with a level of realism that is critical for rapid learning. In crisis management, the most effective protocol familiarization is important to instill confidence in the PPE, workflows and healthcare partners.