Simulation of Cervical Changes in Labour: Reproducibility of Expert Assessment

D, Tuffnell; Johnson, Nicholas; Bryce, Fiona C.; Lilford, R J

doi:10.1016/s0140-6736(89)91094-5

Cited by 61 publications

(53 citation statements)

References 2 publications

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“…Phelps et al 1 found an overall accuracy for determining the exact diameter of 56.3%. Tuffnell et al 25 found a similar overall accuracy of 48.6%. Both studies noted that the accuracy of the examination decreased as cervical dilatation increased.…”

Section: Discussionmentioning

confidence: 80%

“…24 There is little research to support this perception as the accuracy of digital examination of the cervix has been found to be inherently imprecise. The classic studies of Phelps et al 1 and Tuffnell et al 25 used hard cervical models in which the cervix is fixed in position to measure the accuracy of midwives and obstetricians in measuring cervical dilatation. Phelps et al 1 found an overall accuracy for determining the exact diameter of 56.3%.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study which utilised more realistic soft cervical models found that only 19% of cervical dilatation measurements were accurate. 26 It is important to note that the hard cervical models utilised by Phelps et al 1 and Tuffnell et al 25 do not take into account the elasticity of the human cervix. Because of this flexibility, a cervix which has dilated to 4 cm can be stretched on examination to 6-7 cm.…”

Section: Discussionmentioning

confidence: 99%

“…individuals did not always over or underestimate the measurement. 25 Alternative methods of assessing labour progress are routinely utilised by midwives including monitoring the patterns of uterine contractions and measuring descent and flexion of the foetal head by abdominal palpation. Others such as, appearance, vocalisations and behaviour of the mother have been suggested.…”

Section: Discussionmentioning

confidence: 99%

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The frequency and reasons for vaginal examinations in labour

Shepherd

Cheyne

2013

Women and Birth

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The frequency and reasons for vaginal examinations in labour

Shepherd

Cheyne

2013

Women and Birth

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“…When participating in a simulation, learners are often asked to suspend their disbelief to some degree in exchange for variable degrees of physical, conceptual, and emotional fidelity. 9 Published reports describe simulations measuring skills including performing cervical dilation, 10 performing ultrasoundguided amniocentesis, 11 conducting breech delivery, 12 and managing obstetric emergencies and trauma. [13][14][15][16] For the most part, gynecologic simulators mirror those used to teach obstetric techniques: objects, box trainers, or task trainers (some equipped with sensors and computer-based software that provide feedback to the user).…”

Section: Reznick and Colleaguesmentioning

confidence: 99%

Grommets and Glue Guns: Standardization of a Pfannenstiel Model for Low-Fidelity Obstetrics-Gynecology Education

Best¹,

Seibel²,

Lyon³

2009

Journal of Graduate Medical Education

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Objective To validate standardized instructions for the creation, implementation, and performance assessment of a low-fidelity model for Pfannenstiel incision. Study Design The Pfannenstiel model used at the University of Florida-Jacksonville was broken down into composite steps and constructed by obstetrics-gynecology faculty from across the country. The model was then utilized at participants' home institutions and evaluated with respect to realism of the model, ability to replicate the simulation, appropriateness of the skills checklists, and perceived utility of a publication of similarly catalogued simulation modules for use in obstetrics-gynecology training programs. Results The model was correctly constructed by 94.7% (18 of 19) participants and 72.2% (13 of 18) completed a post construction/post simulation survey indicating a high degree of perceived educational utility, feasibility of construction, and desire for additional catalogued modules. Conclusions A low-fidelity simulation model was developed, successfully reproduced using inexpensive materials, and implemented across multiple training programs. This model can serve as a template for developing, standardizing and cataloging other low-fidelity simulations for use in resident education. As discussions among medical educators continue regarding further restrictions on duty hours, it is highly likely that more programs will be looking for guidance in establishing quick, inexpensive, and reliable means of developing and assessing surgical skills in their learners. Furthermore, the Accreditation Council for Graduate Medical Education (ACGME) has well-defined goals of programs developing better and more reproducible tools for all of their assessments. For programs with limited resources, preparing and disseminating reproducible, validated tools could be invaluable in complying with future ACGME mandates.

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The views of pregnant women, midwives, and a women's panel on intrapartum ultrasound research: A pilot study

Wilkinson

Usman

Barton

et al. 2019

Australas J Ultrason Med

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Background: Ultrasound is increasingly used in labour; however, little data exist on attitudes to its use. We sought to analyse and compare the views of pregnant women, midwives, and a women's panel on the value and use of ultrasound in labour. Methods: Focus groups involving a short presentation on ultrasound, questionnaire, and a question and answer session were held with groups of pregnant women, midwives at 2 inner-city maternity units, and a RCOG online Women's Panel. Data were collected on attitudes to vaginal examination, ultrasound, predicting Caesarean section, and the utility of a digital representation of labour. Results: Twenty one midwives and 29 service users (19 pregnant women and 10 women's panel members) participated. Significantly more service users saw positive value in intrapartum ultrasound (P = 0.0005) and predicting Caesarean section (P = 0.03) than midwives. The majority of both groups -72% (20/29) and 62% (13/21), respectivelythought women would want a digital representation of their labour, with the most popular format being on a mobile phone (56%, 20/36). Conclusions: Service users were most and midwives least positive about ultrasound versus vaginal examination, indicating divergence between midwives' perspective of women's need to understand risk and desire to know about their labour. Women found the non-intrusive nature and accuracy of ultrasound valuable while midwives were concerned about de-skilling and medicalisation of birth. All groups felt a graphical representation of labour on a device would be helpful.

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Simulation of Cervical Changes in Labour: Reproducibility of Expert Assessment

Cited by 61 publications

References 2 publications

The frequency and reasons for vaginal examinations in labour

The frequency and reasons for vaginal examinations in labour

Grommets and Glue Guns: Standardization of a Pfannenstiel Model for Low-Fidelity Obstetrics-Gynecology Education

The views of pregnant women, midwives, and a women's panel on intrapartum ultrasound research: A pilot study

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