Jyothshna Bayya

Improved performance of maternal-fetal medicine staff after maternal cardiac arrest simulation-based training

OBJECTIVE To determine the impact of simulation-based maternal cardiac arrest training on performance, knowledge, and confidence among Maternal-Fetal Medicine staff. STUDY DESIGN Maternal-Fetal Medicine staff (n = 19) participated in a maternal arrest simulation program. Based on evaluation of performance during initial simulations, an intervention was designed including: basic life support course, advanced cardiac life support pregnancy modification lecture, and simulation practice. Postintervention evaluative simulations were performed. All simulations included a knowledge test, confidence survey, and debriefing. A checklist with 9 pregnancy modification (maternal) and 16 critical care (25 total) tasks was used for scoring. RESULTS Postintervention scores reflected statistically significant improvement. Maternal-Fetal Medicine staff demonstrated statistically significant improvement in timely initiation of cardiopulmonary resuscitation (120 vs 32 seconds, P = .042) and cesarean delivery (240 vs 159 seconds, P = .017). CONCLUSION Prompt cardiopulmonary resuscitation initiation and pregnancy modifications application are critical in maternal and fetal survival during cardiac arrest. Simulation is a useful tool for Maternal-Fetal Medicine staff to improve skills, knowledge, and confidence in the management of this catastrophic event.

Tamoxifen and growth of an extrauterine leiomyoma

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The relationship of praise/criticism to learning during obstetrical simulation: a randomized clinical trial.

Abstract Aims: The effect of positive vs. negative comments (praise vs. criticism) on trainees’ subsequent cognitive and technical performance is unknown, but of potential importance. We performed a randomized trial of giving either praise or criticism during simulated normal vaginal deliveries (using a high-fidelity birthing simulator) to assess the differential effect of these types of comments on students’ cognitive and technical performance, and perceived confidence after their learning experience. Methods: Medical and nursing students underwent stratified randomization to praise or criticism. Students (n=59) initially participated in a teaching demonstration and practiced normal spontaneous vaginal delivery using a birthing simulator. A baseline assessment of cognitive and technical skills, and of self-confidence, was followed by a second simulation during which positive or negative comments were given using standardized scripts. Cognitive performance, technical performance and confidence measures were then scored again. Results: Cognitive and technical performance scores in the “praise” group improved significantly by 2.5 (P=0.007) and 1.8 (P=0.032), respectively, while those in the “criticism” group remained unchanged. The self-reported confidence scores did not show any significant change from baseline in either group. Conclusions: Praise strengthens students’ cognitive and technical performances, while criticism does not.