• Shad Deering, Jill Brown, Jonathon Hodor, and Andrew J Satin.
• Madigan Army Medical Center, Tacoma, Washington, USA. deering95@hotmail.com
• Obstet Gynecol. 2006 Jan 1; 107 (1): 86-9.

ObjectiveTo determine whether simulation training improves resident competency in the management of a simulated vaginal breech delivery.MethodsWithout advance notice or training, residents from 2 obstetrics and gynecology residency programs participated in a standardized simulation scenario of management of an imminent term vaginal breech delivery. The scenario used an obstetric birth simulator and human actors, with the encounters digitally recorded. Residents then received a training session with the simulator on the proper techniques for vaginal breech delivery. Two weeks later they were retested using a similar simulation scenario. A physician, blinded to training status, graded the residents' performance using a standardized evaluation sheet. Statistical analysis included the Wilcoxon signed rank test, McNemar chi2, regression analysis, and paired t test as appropriate with a P value of less than .05 considered significant.ResultsTwenty residents from 2 institutions completed all parts of the study protocol. Trained residents had significantly higher scores in 8 of 12 critical delivery components (P < .05). Overall performance of the delivery and safety in performing the delivery also improved significantly (P = .001 for both).ConclusionSimulation training improved resident performance in the management of a simulated vaginal breech delivery. Performance of a term breech vaginal delivery is well suited for simulation training, because it is uncommon and inevitable, and improper technique may result in significant injury.Level Of EvidenceII-2.

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