Educational efficacy of the simulation-based episiotomy training: a multi-center observational study.

Background: Interprofessional training programmes are now widely used for training junior doctors and nurses. This study aimed to evaluate the educational efficacy of an obstetric operative simulation programme in both junior and senior obstetricians and midwives.

Methods: We conducted a 30-minute professional course in midwifery at three obstetric centers in Zhejiang, China. The course mainly aimed at improving the knowledge and techniques of mediolateral episiotomies (MLE). Both junior and senior obstetricians and midwives were recruited for evaluation. A questionnaire was completed by all participants at the beginning. Systematic evaluation of individual's MLE skills were compared and analysed before and after the instructional session. The primary outcome was length of the episiotomy incision (mm). The secondary outcomes were the distance from the starting point of the incision to the fourchette (mm); and the perpendicular angle of incision (degrees). Continuous variables were presented as means ± SD or medians and ranges, with Student's t-test used for comparisons between groups. Categorical variables are presented as rates, and the chi-square test was employed to assess differences between proportions. Data were analysed using SPSS statistical software (version 19), with P < 0.05 was considered statistically significant.

Results: Eighty-two participants (35 obstetricians and 47 midwives) joined this programme, of which, 29 were junior obstetrics professionals and 53 were senior obstetrics professionals. Midwives had more MLE training and hands-on experience than obstetricians (p < 0.01). At the end of the programme, the mean values of the three main parameters of MLE were significantly improved in most perinatal care providers. Moreover, midwives, particularly senior midwives, benefited more after the programme, with the incision length and accuracy of MLE improved significantly (P < 0.01).

Conclusions: Operative obstetric simulation training with appropriate instructions should be advocated. Both junior and senior perinatal care providers can benefit from the educational programme. Senior midwives may particularly benefit in their respective fields.