Learning curves of normal real-life vaginal delivery for residents in department of obstetrics and gynecology
10.3969/j.issn.1672-8467.2025.04.011
- VernacularTitle:真实场景中妇产科住院医师的顺产接生学习曲线
- Author:
Yan XU
1
;
Jun GUAN
1
;
Chang-en XU
1
;
Qing-ying ZHANG
1
;
Xian XIA
1
Author Information
1. 复旦大学附属妇产科医院产科 上海 200090
- Publication Type:Journal Article
- Keywords:
vaginal;
delivery;
learning curve;
simulation training;
department of obstetrics and gynecology,resident
- From:
Fudan University Journal of Medical Sciences
2025;52(4):544-549
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the learning curve of real-life vaginal delivery,including its difficult steps and influencing factors,to optimize the future training of vaginal delivery for residents in department of obstetrics and gynecology.Methods From 25 Sep 2020 to 12 Mar 2022,OBGYN residents without previous experiences in vaginal delivery were prospectively enrolled in Obstetrics and Gynecology Hospital,Fudan University.Residents performed normal vaginal delivery under the supervision of senior obstetricians and midwives.The performance score(PS)of vaginal delivery and its 9 steps were evaluated via a questionnaire fulfilled by the supervisor once each delivery was finished.Logistic regression models were performed for univariate and multivariate analyses to evaluate the factors that might be correlated with the PS.Results Eventually,233 deliveries performed by 60 residents were analyzed.Results showed that more than 10 deliveries were needed for 70%of residents to obtain minimal competence of vaginal delivery.Perineal protection,delivery of the fetal head,delivery of the fetal shoulders and repair of episiotomy or laceration were found to be the most difficult steps,which required more practices to achieve minimal competence level.Univariate analyses showed the delivery experience,the times of observation/simulation/training,and humanistic care skills might influence the total PS(P<0.05).However,only delivery experience(OR=1.43,95%CI:1.22-1.67)and the times of observation(OR=1.02,95%CI:1.00-1.04)were found to be independently correlated with the total PS in multivariate analyses.Conclusion More than 10 real-life practices were required to achieve the minimal competence of normal vaginal delivery.Enhancing the training on the four difficult steps of vaginal delivery might improve the learning efficiency when delivery opportunities are limited.
