Implementation and evaluation of a dilation and evacuation simulation training curriculum

York, Sloane L.; McGaghie, William C.; Kiley, Jessica; Hammond, Christopher J.

doi:10.1016/j.contraception.2016.02.002

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…In obstetrics, simulation training has been found to be effective in previous studies [ 40 , 41 ]. Simulator training can be used as a tool for learning fundamental skills, can help with counseling and communication, and can encourage discussion [ 42 ]. It is well documented that well-equipped simulation laboratories contribute to effective teaching [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study

Nkurunziza,

Habtu,

Mukeshimana

et al. 2024

PLoS ONE

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Introduction Comprehensive abortion care is an emerging intervention being integrated into nursing and midwifery curricula. Yet, no studies have been conducted in Rwanda to determine whether faculty perceive themselves as capable of teaching comprehensive abortion care. This study aims to evaluate the perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda. Materials and methods The University of Rwanda College of Medicine and Health Sciences Institutional Review Board approved this study (UR-CMHS-IRB No 335/CMHSIRB/2022). In quantitative, a self-administered questionnaire was administered to 98 study participants. Data were entered into Statistical Package for the Social Sciences (SPSS) version 26 and analyzed using Chi-square test with a p-value of 0.05 set as the significance level. In the qualitative part, an interview guide was developed based on quantitative data to understand comprehensive abortion care teaching fully. Data were collected from four focus group discussions with eight participants in each group, entered in Dedoose, and analyzed thematically. Results Among the 98 study participants who were invited to participate in this study, only 85 filled out the questionnaires. This translates into 86.7% of the response rate. More than half 58.8% had adequate self-efficacy in teaching comprehensive abortion care. A Chi-square test has revealed that being a male, being a midwife, and having more years of working experience in nursing education were significantly associated with self-efficacy in teaching comprehensive abortion care (p value <0.05). In the qualitative phase, 32 study participants participated in four focus group discussions and four themes were identified: a) variability in confidence levels to teach comprehensive abortion care; b) readiness about teaching comprehensive abortion care; c) facilitators of teaching comprehensive abortion care; and d) contextual challenges to teach comprehensive abortion care. Conclusions The findings revealed that faculty’s self-efficacy in teaching comprehensive abortion care was not adequate. Personal and religious beliefs and institutional barriers were also reported to hinder self-efficacy in teaching comprehensive abortion care. Therefore, intensive comprehensive abortion care training for nursing and midwifery faculty in higher learning institutions should be provided, including values clarification and attitude transformation training for attitudes and beliefs. It is also critical for higher learning institutions to develop strategies for overcoming the challenges faculty face when teaching comprehensive abortion care.

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Section: Discussionmentioning

confidence: 99%

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study

Nkurunziza,

Habtu,

Mukeshimana

et al. 2024

PLoS ONE

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show abstract

“…To address this need, we created and assessed a high-fidelity simulation designed to improve OB/GYN residents’ knowledge, confidence, and competence performing a second-trimester D&E and managing postprocedural hemorrhage, the most common serious complication of D&E. Prior studies have described the use of both low-fidelity 14 and partial trainer simulation models 15 , 16 for second-trimester D&E training that focus on the uterine evacuation portion of the procedure and were found to improve resident technical skill. Additional D&E simulation resources are publicly available but have not yet been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Second-Trimester Dilation and Evacuation: A Simulation-Based Team Training Curriculum

Schwartz,

Pelletier,

Goldberg

et al. 2023

MedEdPORTAL

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Introduction Despite the need for providers skilled in second-trimester dilation and evacuation (D&E) procedures, there are few second-trimester abortion training opportunities for OB/GYN residents and other health care trainees. Barriers to such training include restrictive state laws and institutional policies, lack of trained faculty, and limited procedural volume. Simulation-based D&E training is, therefore, a critical tool for OB/GYN residents and other medical professionals to achieve clinical competency. Methods This simulation for OB/GYN residents centers on a 29-year-old woman at 18 weeks gestation with intrauterine fetal demise, requiring learners to perform a second-trimester D&E and manage an unexpected postprocedural hemorrhage. We designed the simulation to be used with a high-fidelity mannequin. Personnel roles required for the simulation included an anesthesiologist, medical assistant, OR nurse, and two OB/GYN faculty. Learner performance was assessed using a pre- and postsimulation learner evaluation, a critical action checklist, and a focus group with simulation facilitators. Results Forty-nine residents participated over an 8-year period. Learners demonstrated improved competency performing a second-trimester D&E and increased confidence managing postprocedural hemorrhage after participating in this simulation. In addition, focus group participants reported that a majority of learners demonstrated confidence and effective communication with team members while performing in a decision-making role. Discussion In addition to improving learners’ clinical competency and surgical confidence for second-trimester D&E procedures, this simulation serves as a valuable instrument for the standardized assessment of learners’ performance, as well as an opportunity for all participants to practice teamwork and communication in a high-acuity setting.

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“…Learning procedures under mastery learning models is effective in both procedure heavy disciplines, such as surgery, as well as primary care specialties such as internal medicine, pediatrics, or obstetrics and gynecology [12][13][14][15]. Mastery learning models that incorporate deliberate practice, the process of performing the skill under direct observation of an instructor with immediate formative feedback, are favored to traditional frameworks such as the common apprenticeship 'see one, do one' technique that only requires learners to demonstrate rudimentary skill [16,17].…”

Section: Introductionmentioning

confidence: 99%

How general pediatricians learn procedures: implications for training and practice

Iyer

Way

Schumacher

et al. 2021

Medical Education Online

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The Accreditation Council for Graduate Medical Education (ACGME) requires General Pediatricians (GPeds) to learn thirteen procedures during training. However, GPeds infrequently perform these procedures in practice. We sought to determine:1) how GPeds learned procedures, 2) if GPeds self-reported achieving competence in the required ACGME procedures during training, and 3) if GPeds maintained these skills into practice. We conducted this mixed methods study from 2019-2020. 51 GPeds from central Ohio and the American Board of Pediatrics General Examination Committee were recruited via email or snowball sampling and participated in semi-structured recorded phone interviews probing procedural performance during training and current practice. Participants represented varied geographic regions and clinical settings. We employed Sawyer's 'Learn, See, Practice, Prove, Do, Maintain' mastery learning pedagogical framework as a lens for thematic analysis. Participants did not demonstrate competence in all ACGME required procedures during training, nor sustain procedural skills in practice. Most participants learned procedures through a 'see one, do one' apprenticeship model. GPeds reported never being formally assessed on procedural competence during residency. All GPeds referred out at least one procedure. GPeds also believed that skill maintenance was unwarranted for procedures irrelevant to their current practice. GPeds did not sufficiently demonstrate competence in all ACGME required procedures during training, partially suggesting why they infrequently perform some procedures. Alternatively, these required procedures may not be relevant to their practice. Pediatric residency procedures education might consider using mastery learning for practice-specific procedures and surface-level methods (learning without mastery) for other skills.

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Implementation and evaluation of a dilation and evacuation simulation training curriculum

Cited by 7 publications

References 17 publications

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study

Second-Trimester Dilation and Evacuation: A Simulation-Based Team Training Curriculum

How general pediatricians learn procedures: implications for training and practice

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