Rapid Cycle Deliberate Practice Simulation for a Maternal Cardiac Arrest With Obstetrics and Gynecology Residents.

Abstract

Introduction: Maternal cardiac arrest is rare; therefore, simulation serves as an opportunity to better prepare obstetrics and gynecology residents for these emergencies.

Methods: We conducted a 2-hour educational activity for 16 obstetrics and gynecology residents at an academic medical center, utilizing rapid cycle deliberate practice to teach them the recognition and management of a maternal cardiac arrest. The case centered on a patient admitted to the labor and delivery floor who was in her third trimester. She developed chest pain and had a subsequent cardiac arrest. The case used up to seven rounds of rapid cycles with debriefing after each. Learners were expected to recognize the cardiac arrest, initiate initial management, consider the differential diagnosis, and prepare for a resuscitative hysterotomy.

Results: After the simulation case, learners' average comfort level for managing cardiac arrest improved from 1.8 to 3.6 (on a 5-point Likert scale: 1 = extremely uncomfortable, 5 = extremely comfortable). Comfort performing supportive airway management went from 1.9 to 4.1. Residents found the knowledge gained during the session useful to future practice, and the average course rating was 5.8 on a 6-point scale (with 6 = excellent).

Discussion: Rapid cycle deliberate practice simulation for a maternal cardiac arrest improves obstetrics and gynecology residents' comfort and readiness for obstetrics emergencies.