Resident training for eclampsia and magnesium toxicity management: simulation or traditional lecture?

• Published in: American journal of obstetrics and gynecology 2010-10, Vol.203 (4), p.379.e1-379.e5
• Main Authors: Fisher, Nelli, MD, Bernstein, Peter S., MD, MPH, Satin, Andrew, MD, Pardanani, Setul, MD, Heo, Hye, MD, Merkatz, Irwin R., MD, Goffman, Dena, MD
• Format: Article
• Language: English
• Subjects: Anticonvulsants - administration & dosage; Anticonvulsants - adverse effects; Biological and medical sciences; Diseases of mother, fetus and pregnancy; Eclampsia - drug therapy; eclampsia simulation; Female; Gynecology. Andrology. Obstetrics; Humans; Internship and Residency; Magnesium Sulfate - administration & dosage; Magnesium Sulfate - adverse effects; Medical sciences; Medication Errors - prevention & control; obstetric emergencies training; Obstetrics - education; Obstetrics and Gynecology; Patient Simulation; Pregnancy; Pregnancy. Fetus. Placenta; Prospective Studies; resident education; Seizures - prevention & control; Teaching - methods
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.06.010

Objective To compare eclampsia and magnesium toxicity management among residents randomly assigned to lecture or simulation-based education. Study Design Statified by year, residents (n = 38) were randomly assigned to 3 educational intervention groups: Simulation→Lecture, Simulation, and Lecture. Postintervention simulations were performed for all and scored using standardized lists. Maternal, fetal, eclampsia management, and magnesium toxcity scores were assigned. Mann-Whitney U , Wilcoxon rank sum and χ2 tests were used for analysis. Results Postintervention maternal (16 and 15 vs 12; P < .05) and eclampsia (19 vs 16; P < .05) scores were significantly better in simulation based compared with lecture groups. Postintervention magnesium toxcitiy and fetal scores were not different among groups. Lecture added to simulation did not lead to incremental benefit when eclampsia scores were compared between Simulation→Lecture and Simulation (19 vs 19; P = nonsignificant). Conclusion Simulation training is superior to traditional lecture alone for teaching crucial skills for the optimal management of both eclampsia and magnesium toxicity, 2 life-threatening obstetric emergencies.