Simulation and Educational Principles in Obstetric Anesthesiology

The use of simulation in medicine continues to grow and helps improve the clinical outcomes of patients. Obstetric phantoms were used as far back as 1712–1790 when Madame Angelique du Coudray taught midwives and physicians. Simulation in obstetric anesthesia can be divided into four broad uses: training of technical skills [such as Team-Oriented Medical Simulation (TOMS)], training of nontechnical or teamwork skills [various debriefing models are used for communication and Situation-Background-Assessment-Recommendation (SBAR) technique for teamwork skills], evaluation of individual clinical competence, and evaluation of safety of the clinical environment. Simulation models can be high fidelity or low fidelity. High-fidelity manikin-based simulation is better than low-fidelity haptic simulators. However, low-fidelity simulation could be useful in remote areas with limited resources or in situations where a large group of people need to be trained over a short period of time. Simulation-based medical education is of utmost importance in the field of obstetrics, as delivery wards are challenging workplaces where patient safety is high on the agenda and unexpected emergencies occur. In “the zone of simulation matrix,” i.e., opportunity vs acuity plot, four zones of obstetric simulation are obtained to provide teaching and training skills for even infrequently occurring emergencies such as maternal advanced cardiovascular life support scenarios. Although the review literature provides information about the methods of obstetric simulation and its positive short-term impact on clinical judgment and maternal outcome, additional literature is needed to evaluate the long-term change in behavior, teamwork, clinical skills, and knowledge retention with the use of obstetric simulation.