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P60 ‘Filling the gap’: a simulation course for fourth year medical students to enhance understanding of obstetric emergencies

Introduction Obstetrics is a team-based high-risk speciality, where litigation is high. Teamwork failings contribute to adverse outcomes for mothers and babies, therefore, good multiprofessional teamwork is essential.1 Furthermore, team simulation training in obstetrics has been shown to improve neonatal outcomes following obstetric complications.2 Simulation training is used increasingly for training undergraduates as it allows students to consolidate their learning and use their skills and knowledge in practice. Although specialised, the clinical and non-technical skills required for the management of obstetric emergencies including post-partum haemorrhage (PPH) and sepsis are transferable to any emergency. Methods/Project description An obstetric simulation was designed for 4th year medical students at the end of their Obstetrics and Gynaecology placement. Groups of 3–5 students underwent simulated scenarios (lasting 10–20 minutes) with a high-fidelity, integrated mannequin (CAE systems Lucina©) covering PPH, sepsis and eclampsia. Following the scenarios, students participated in a debrief focusing on clinical aspects and the non-technical skills required in each situation. An anonymous online feedback questionnaire was sent out to students at the end of the academic year to gain an insight into opinions on the simulation and how it may be improved. Results Students were extremely positive about the simulation, and felt strongly that it helped consolidate knowledge, helped with non-technical skills, and students felt they would use the knowledge gained from the simulation in their future practice. Students appreciated ‘actually putting into practice theoretical learning’ and felt that ‘it [simulation] gives you the chance to really experience a situation, rather than just reading about it. And in a safe environment’. Students expressed that the simulation component of the Obs and Gynae placement should be increased to at least two sessions over the four-week placement and gave other useful suggestions of how the simulation may be improved. Discussion Overall, the simulation sessions were a success. Student’s feedback was positive, and they demonstrated improved self-reported knowledge and confidence following the sessions. The positive response to simulation may be, in part, due to limited opportunities in the real clinical setting, as the Obs and Gynae placement is only four weeks, making it very difficult for students to experience all that the speciality has to offer. Furthermore, it would be difficult for students to be involved in management of obstetric emergencies in practice. Further work on improving and expanding the simulation training is planned for the next academic year. References MBRRACE-UK. Saving Lives, Improving Mothers’ Care Surveillance of maternal deaths in the UK 2012–14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14. 2016. Draycott TJ. Practical obstetric multiprofessional training - PROMPT. The Health Foundation; 2013 May 2013.