Julien Lepage1, Pierre Francois Ceccaldi2, Sid Ahmed Remini3, Patrick Plaisance4, Audrey Voulgaropoulos5, Dominique Luton6. 1. Hôpital Bichat, Maternité Aline de Crepy, APHP, 75018, Paris, France; Université Paris Diderot, Paris 7, Paris, France. 2. Université Paris Diderot, Paris 7, Paris, France; Hôpital Beaujon, Service de gynécologie obstétrique, APHP, 92110, Clichy, France; Ilumens Paris Diderot, Centre de simulation, Paris, France; DHU Risk and Pregnancy (Paris V and Paris VII University), France. 3. Ilumens Paris Diderot, Centre de simulation, Paris, France. 4. Université Paris Diderot, Paris 7, Paris, France; Ilumens Paris Diderot, Centre de simulation, Paris, France; Hôpital Lariboisière, Emergency Unit, APHP, 75018, Paris, France. 5. Hôpital Bichat, Maternité Aline de Crepy, APHP, 75018, Paris, France. 6. Hôpital Bichat, Maternité Aline de Crepy, APHP, 75018, Paris, France; Université Paris Diderot, Paris 7, Paris, France; Ilumens Paris Diderot, Centre de simulation, Paris, France; DHU Risk and Pregnancy (Paris V and Paris VII University), France. Electronic address: dluton@free.fr.
Abstract
BACKGROUND: Although most societies of obstetrics advocate vaginal delivery of twins, there has been a steady rise in the rate of twin cesarean sections. We risk perhaps losing in a single generation our obstetrical learning and skills because of medicolegal and emotionally charged issues. METHODS: We have therefore designed a realistic as possible simulation model of second twin delivery and tested it on residents in obstetrics. FINDINGS: Between two trials, we noted a significant improvement in the time required for internal podalic version and breech extraction. We also observed a significant improvement in the confidence score between the two trials. INTERPRETATION: We have designed a simulation device that improves obstetrical skills for second twin delivery and which we hope will participate in the comeback of vaginal delivery for this indication and contribute to the fight against the dangerous trend of rising rates of cesarean delivery for twins. Our model completely fits the paradigm of simulation in medical pedagogy.
BACKGROUND: Although most societies of obstetrics advocate vaginal delivery of twins, there has been a steady rise in the rate of twin cesarean sections. We risk perhaps losing in a single generation our obstetrical learning and skills because of medicolegal and emotionally charged issues. METHODS: We have therefore designed a realistic as possible simulation model of second twin delivery and tested it on residents in obstetrics. FINDINGS: Between two trials, we noted a significant improvement in the time required for internal podalic version and breech extraction. We also observed a significant improvement in the confidence score between the two trials. INTERPRETATION: We have designed a simulation device that improves obstetrical skills for second twin delivery and which we hope will participate in the comeback of vaginal delivery for this indication and contribute to the fight against the dangerous trend of rising rates of cesarean delivery for twins. Our model completely fits the paradigm of simulation in medical pedagogy.