Page 224 - Hospital Authority Convention 2017
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Service Enhancement Presentations
      HOSPITAL AUTHORITY CONVENTION 2017


             F7.2      Committed and Happy Staff                                        13:15  Room 421

            Randomised  Controlled  Study  to  Assess  Skill  Retention  at  Six  versus  12  Months  after  Simulation  Training  in
            Shoulder Dystocia
            Lee MHM, Chan CN, Ma TWL
            Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong

            Introduction
            Shoulder dystocia is a relatively uncommon (0.2-3% of all deliveries) but serious obstetrics emergency which can lead to
            severe morbidity and mortality to the delivering fetus. Current evidence suggests that annual training is adequate to maintain
            skills for management of shoulder dystocia.

            Objectives
            To test our hypothesis that skills start to decline at six months and further decline to 12 months after training.

            Methodology
            In this randomised single-blinded study, 12 obstetricians and 42 midwives of our department were randomly assigned to
            attend a one-hour lecture with mixed simulation session on shoulder dystocia in the simulation  centre of our hospital at
            month ‘0’ (group two) or month ‘6’ (group one). Their knowledge score and primary outcome were assessed before and
            immediately after the training, and subsequently retested at month ‘12’. Time taken to complete the simulation scenario
            (secondary outcome) was similarly assessed. Subgroup analysis was also performed after separating the data into doctors
            only and midwives only.

            Results
            Compared to pre-training, the drill score increased immediately after (or at-) the simulation training in both group one (8.26
            vs 14.26, p<0.001) and group two (9.46 vs 14.69, p< 0.001), but decreased at six months post-training in group one (14.26 vs
            11.54, p<0.001) and at 12 months post-training in group two (14.69 vs 11.54, p< 0.001), though to a level which was still better
            before the training. There was no difference in the decline in score from at-training to post -training between group one and
            group two (-2.63 vs -2.81, p=0.790). Similar trend was found regarding time required to complete the simulated scenario.
            Subgroup analysis was performed separately for obstetricians and midwives where similar trends were found.
            Conclusion
            The study demonstrated that simulation training results in immediate improvement in shoulder dystocia management,
            however knowledge degrades over time. Ongoing training is suggested at a minimum of 12 months interval but ideally at six
            months interval for both doctors and midwives.




      Wednesday, 17 May



































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