Improving shoulder dystocia management among resident and attending physicians using simulations

Dena Goffman, Hye Heo, Setul Pardanani, Irwin R. Merkatz, Peter S. Bernstein

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Objective: The objective of the study was to determine whether a simulation-based educational program would improve residents' and attending physicians' performance in a simulated shoulder dystocia. Study Design: Seventy-one obstetricians participated in an unanticipated simulated shoulder dystocia, an educational debriefing session, and a subsequent shoulder dystocia simulation. Each simulation was scored, based on standardized checklists for 4 technical maneuvers and 6 communication tasks, by 2 physician observers. Paired Student t tests were used for analysis. Results: Forty-three attendings and 28 residents participated. Residents showed significant improvement in mean maneuver (3.3 ± 0.9 vs 3.9 ± 0.4, P = .001) and communication (3.5 ± 1.2 vs 4.9 ± 1.0, P < .0001) scores after simulation training. Attending physicians' communication (3.6 ± 1.6 vs 4.9 ± 1.1, P < .0001) scores were significantly improved after training. Conclusion: Our program improved physician performance in the management of simulated shoulder dystocia deliveries. Obstetric emergency simulation training can improve physicians' communication skills, at all levels of training, and should be incorporated into labor and delivery quality improvement measures.

Original languageEnglish (US)
Pages (from-to)294.e1-294.e5
JournalAmerican journal of obstetrics and gynecology
Issue number3
StatePublished - Sep 2008


  • obstetric birth simulator
  • shoulder dystocia simulation

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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