Retention of skills 2 years after completion of a postpartum hemorrhage simulation training program in rural Rwanda

• Published in: International journal of gynecology and obstetrics 2016-09, Vol.134 (3), p.350-353
• Main Authors: Nathan, Lisa M, Patauli, Desire, Nsabimana, Damien, Bernstein, Peter S, Rulisa, Stephen, Goffman, Dena
• Format: Article
• Language: English
• Subjects: Clinical Competence; Computer Simulation; Emergency obstetric training; Female; Humans; Inservice Training; Male; Maternal Health Services; Obstetrics and Gynecology; Postpartum hemorrhage; Postpartum Hemorrhage - therapy; Pregnancy; Program Evaluation; Rural Health Services; Rwanda; Simulation training
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2016.01.021

Abstract Objective To evaluate the long-term retention of skills gained by rural physicians who completed a postpartum hemorrhage simulation-training program. Methods A quasi-experimental pre–post intervention study enrolled a convenience sample of generalist physicians in rural Rwanda. Participants underwent initial simulation training including pre- and post-training testing in February 2012. Simulation drills to assess skill retention were conducted in March 2014. Participants were scored based on their communication, evaluation, and management skills. Median scores and inter-quartile ranges were calculated and the Wilcoxon signed-rank sum test was used to compare the pre-training, post-training, and retention scores. Physician confidence was assessed using a survey. Results In total, 11 physicians were enrolled; eight were available for the 2-year skill-retention evaluation. Significant improvements were observed when comparing participants’ pre-training and post-training communication ( P = 0.03), evaluation ( P = 0.05), and management ( P = 0.02) scores, and there were no changes between participants’ post-training and 2-year communication ( P > 0.99), evaluation ( P = 0.16), and management ( P = 0.46) scores. There were no differences in the self-reported confidence measures across the duration of the study. Conclusion Simulation training is an effective method for teaching postpartum hemorrhage-management skills to generalist physicians in rural areas and skills are retained for at least 2 years. Further studies could determine the optimal time intervals for refresher training.