Training and testing of integrated professional skills in management of shoulder dystocia among Malaysian Health Care Providers

INTRODUCTION: To evaluate if the Intensive Course in Obstetric Emergencies (ICOE) Shoulder dystocia simulation training module could improve psychomotor and cognitive skills in the management of shoulder dystocia using a Test of Integrated Professional Skills (TIPS).

MATERIALS AND METHOD: This was a prospective observational study involving Malaysian health care professionals participating in ICOE shoulder dystocia simulation, where standardized curriculum was used. Pre and post-test skills assessment were conducted to evaluate the effectiveness of the course content and delivery.

RESULTS: 609 Malaysian health care professionals attended ICOE training; 400 midwives, 128 medical officers, 55 specialist and 26 consultants. Participants were derived from 25 consecutive courses, from 2014 to 2019 and tested on predetermined skills in the management of shoulder dystocia. Their mean TIPS pre-test vs post-test score were (2.55 vs 6.77) midwives, (3.78 vs 7.25) medical officers, (5.16 vs 7.82) specialists & (3.62 vs 6.88) consultants. All four group of participants showed statistically significant improvement (51-165%) in their skills (p<0.001). The mean post test score in noting time of dystocia and call for help were significantly higher among midwives than others. All four groups statistically improved their delivery skills in McRoberts manoeuvre and directed suprapubic pressure. Pre-skills for delivery of the posterior arm was suboptimal and post skills test showed statistically significant improvement in all four groups.

CONCLUSION: ICOE shoulder dystocia simulation training module improved the psychomotor and cognitive skills in the management of delivery of shoulder dystocia.