Improving preparedness of emergency medicine residents in the management of postpartum hemorrhage: A randomized controlled study of two pedagogical approaches.

Objective: To evaluate a novel curriculum to enhance knowledge and preparedness of emergency medicine (EM) residents in the management of postpartum hemorrhage (PPH).

Methods: A randomized controlled trial examining two pedagogical approaches. Following baseline testing of knowledge and confidence in respect of PPH management, participants were randomized to receive a didactic lecture on PPH management (group A, n = 14) or a didactic lecture followed by simulation-based training on PPH management and debriefing (group B, n = 16). Post-intervention, proficiency in PPH management was evaluated by clinical skills simulation and post-intervention assessment for participants. The change in the mean test and clinical skills scores were compared using Student's t-test. Linear regression examined the effects of covariates.

Results: Both forms of intervention increased participants' knowledge of (group A: mean = 2.50, 95% confidence interval [CI] 1.63-3.37, P < 0.001; group B: mean = 1.56, 95% CI 0.89-2.24, P < 0.001) and confidence in PPH management (group A: mean = 1.00, 95% CI 0.46-1.54, P = 0.003; group B: mean = 1.00, 95% CI 0.52-1.48, P = 0.001), relative to baseline. However, addition of simulation and debriefing to the didactic session did not offer any advantage (knowledge: mean = -0.94, 95% CI -1.97 to 0.10, P = 0.074; confidence: mean = 0.00, 95% CI -0.66 to 0.66, P = 1.000).

Conclusion: Delivery of a structured curriculum led to improvement of knowledge and confidence with regard to the management of PPH by EM residents.