Vacuum Delivery – What is the Better Training Approach?
BACKGROUND AND PURPOSE:
Medical students are taught how to perform procedures through both hands-on training and through watching expert demonstrations. At the time of this study, there was no published data on the validity of various training methods for vacuum extraction (VE)
This study by Hilal et al. (Medicine, 2017) sought to determine if hands-on training or video (expert) demonstration is more effective for teaching vaginal delivery using VE
Randomized Controlled Trial (RCT), single-blinded (assessor unaware of group allotment)
137 medical students were randomized (each arm was 30 minutes each)
74 students watched an expert video demonstration where the pelvic training model appears in the film (group 1)
63 students participated in hands-on training using a pelvic training model (group 2)
Students were tested using a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system following training and four days later
Students in group 2 had higher OSATS scores than those in group 1 (32.89 ± 6.39 vs. 27.51 ± 10.27, respectively; P < 0.0001)
Group 2 did better than group 1 in the global rating scale (1.49 ± 0.76 vs. 2.33 ± 0.94, respectively; P < 0.0001), confidence (2.22 ± 0.75 vs. 3.26 ± 0.94, respectively; P = 0.04), self-assessment (2.03 ± 0.62 vs. 2.51 ± 0.77, respectively; P < 0.0001), and performance time (38.81 ± 11.58 seconds vs. 47.23 ± 17.35 seconds, respectively; P = 0.001)
These results persisted at the assessment four days after training
OSATS scores in group 2 remained higher than group 1 (30.00 ± 6.50 vs 25.59 ± 6.09, respectively; P = 0.001)
For teaching VE on a pelvic model, hands-on training is more effective than an expert video demonstration
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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