Improving Preparedness of Emergency Medicine Residents in the Management Postpartum Hemorrhage: a randomized controlled study of two pedagogical approaches
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine. YMS II, Yale School of Medicine. Department of Emergency Medicine Yale School of Medicine .
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2022
OBJECTIVE To evaluate a novel curriculum to enhance knowledge and preparedness of Emergency Medicine (EM) residents in the management of postpartum hemorrhage (PPH) METHODS A randomized controlled trial examined two pedagogical approaches. Following baseline testing of knowledge and confidence in PPH management, participants were randomized to receive a didactic lecture on PPH management (group A, n=14) or to the didactic
lecture followed by simulation-based training on PPH management and debriefing (group B, n=16). Post-intervention, proficiency in PPH management was evaluated by clinical skills simulation and post-intervention assessment for participants. The change in the mean test and clinical skills scores were compared using student's t test. Linear regression examined the effects of covariates. RESULTS Both forms of intervention increased participants' knowledge (group A: mean=2.50 CI (1.63, 3.37), p<0.001; group B: mean=1.56 CI (0.89, 2.24), p<0.001) of and confidence (group A: mean=1.00 (0.46, 1.54),p=0.003; group B: mean=1.00 CI (0.52, 1.48),p=0.001) in PPH management, relative to baseline. However, addition of simulation and debriefing to didactic session did not offer any advantage (knowledge: mean=-0.94 CI (-1.97, 0.10), p=0.074; confidence: mean=0.00 CI (-0.66,0.66), p=1.000). CONCLUSION Delivery of a structured curriculum led to improvement of knowledge and confidence in the management of PPH by EM residents.
