Near-Peer-Led Spontaneous Vaginal Delivery Simulation Improves Clerkship Students' Knowledge and Confidence.

Abstract

Introduction: This study aims to evaluate a near-peer-led, low-fidelity spontaneous vaginal delivery (SVD) simulation on Obstetrics and Gynecology (OB/Gyn) clerkship medical students' knowledge, self-perceived confidence, and experiences.

Methods: A pre-post intervention study was performed. Senior undergraduate medical students (MS4s) served as near-peer teachers and presented an SVD lecture and simulation session using a low-fidelity manikin to clerkship students on the first day of the Ob/Gyn clerkship. Demographics, knowledge, confidence, and experience were assessed via anonymous surveys at three points: pre-simulation, post-simulation, and post-clerkship. Students who completed the rotation in the preceding 1 year (prior to simulation implementation) served as controls.

Results: 259 clerkship students completed pre- and post-simulation surveys with 71 also completing post-clerkship surveys. 54 students served as controls. Post-simulation knowledge scores were significantly greater than pre-simulation and controls (76.9% vs. 54.5%, p< 0.01; 76.9% vs. 53.3%, p < .01). Knowledge increased, though not significantly, from post-simulation to post-clerkship (76.9% vs. 84.1%, p=0.07). Ob/Gyn clerkship student confidence significantly increased for all components of the vaginal delivery immediately following simulation (p <.01). Following the clerkship, students were more confident delivering and examining the placenta than immediately following the simulation (3.6 vs. 3.4, p=0.03; 3.6 vs. 3.3, p=0.04, respectively). Participation in delivery of placentas and infants did not significantly differ between students who completed the simulation and controls (3(3) vs. 3(3), p=0.32; 1(2) vs. 2(4), p=0.32, respectively).

Conclusion: A 90-minute SVD simulation session at the start of the Ob/Gyn clerkship led by near-peers is feasible and significantly increases clerkship students' knowledge and confidence to participate in an SVD.