Exploratory randomized controlled trial of hybrid obstetric simulation training for undergraduate students

BACKGROUND: Introducing novel methods in undergraduate teaching of obstetrics and gynecology has been recommended. High-fidelity simulation of shoulder dystocia has been shown to improve skills of qualified maternity staff. We aimed to assess whether simulation is also useful for improving medical students' skills. METHODS: Twenty-four medical students were recruited. Training consisted of a high-fidelity simulation teaching session for all 24 students and a refresher session for which the same students were randomly allocated to two groups. Half attended a small-group tutorial (SGT) and half a simulation session with a patient-actor (hybrid simulation, HYB). Afterward, they were asked to deliver a baby with simulated shoulder dystocia. We assessed their practical skills and compared communication skills between SGT and HYB. Primary outcome measure was their communication score, using a validated scale. Secondary measure was the students' ability to deliver the baby appropriately. RESULTS: Posttraining, all students managed delivery appropriately. Group HYB had significantly higher median total patient perception scores (11 simulation versus 9 tutorial, P = 0.0239, Mann-Whitney) than SGT. CONCLUSION: High-fidelity simulation can be used to train and evaluate learning. The use of patient-actors during simulation improves students' communication skills. Future research should assess whether this translates into better communication with real patients.