First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage

Introduction Serious complications associated with first-trimester abortions are rare. The US mortality rate for these procedures is 0.7 per 100,000, primarily due to infection and hemorrhage. While complications are unlikely to arise during training, residents must be prepared to manage them in pra...

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Autores principales:	Armide Storey, Katharine White, Kelly Treder, Elisabeth Woodhams, Shannon Bell, Rachel Cannon
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2020
Materias:	Simulation Abortion Uterine Aspiration Complication Infection Sepsis Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/f9b01ee4617b418e9a81a794a75370e3
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spelling	oai:doaj.org-article:f9b01ee4617b418e9a81a794a75370e32021-11-19T14:50:02ZFirst-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage10.15766/mep_2374-8265.109952374-8265https://doaj.org/article/f9b01ee4617b418e9a81a794a75370e32020-10-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10995https://doaj.org/toc/2374-8265Introduction Serious complications associated with first-trimester abortions are rare. The US mortality rate for these procedures is 0.7 per 100,000, primarily due to infection and hemorrhage. While complications are unlikely to arise during training, residents must be prepared to manage them in practice. To address this, we developed a 2-hour simulation-based abortion complication curriculum for OB/GYN resident learners. Methods OB/GYN residents participated in three sessions: a case-based didactic reviewing institutional aspiration abortion practice and preop preparation; an in-vivo aspiration abortion hemorrhage simulation; and an interdepartmental postabortal sepsis simulation. Participants completed surveys before and after their participation that evaluated clinical knowledge, and self-rated competence in, and preparedness for, managing first-trimester abortion complications. Results Resident learners (N = 26) represented all four classes of OB/GYN residents. Residents initially showed stronger clinical knowledge in managing postabortal hemorrhage than sepsis (90% vs. 62%, p < .001). Clinical knowledge improved following the sepsis simulation (62% to 91%, p < .001), and remained strong but unchanged after the hemorrhage simulation (90% to 87%, p = .3). Resident self-assessments of competence and preparedness were significantly improved after both the hemorrhage (p = .006) and sepsis (p = .002) simulations. Learners reported that the simulation increased their level of comfort in managing these complications in their future practice. Discussion Postabortal hemorrhage and sepsis simulations increased OB/GYN residents' knowledge, comfort, and preparedness for managing rare complications of first-trimester abortions. In-vivo simulation and interdepartmental collaboration were novel aspects of these simulations that may facilitate increased preparedness and management skills.Armide StoreyKatharine WhiteKelly TrederElisabeth WoodhamsShannon BellRachel CannonAssociation of American Medical CollegesarticleSimulationAbortionUterine AspirationComplicationInfectionSepsisMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 16 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Simulation Abortion Uterine Aspiration Complication Infection Sepsis Medicine (General) R5-920 Education L
spellingShingle	Simulation Abortion Uterine Aspiration Complication Infection Sepsis Medicine (General) R5-920 Education L Armide Storey Katharine White Kelly Treder Elisabeth Woodhams Shannon Bell Rachel Cannon First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage
description	Introduction Serious complications associated with first-trimester abortions are rare. The US mortality rate for these procedures is 0.7 per 100,000, primarily due to infection and hemorrhage. While complications are unlikely to arise during training, residents must be prepared to manage them in practice. To address this, we developed a 2-hour simulation-based abortion complication curriculum for OB/GYN resident learners. Methods OB/GYN residents participated in three sessions: a case-based didactic reviewing institutional aspiration abortion practice and preop preparation; an in-vivo aspiration abortion hemorrhage simulation; and an interdepartmental postabortal sepsis simulation. Participants completed surveys before and after their participation that evaluated clinical knowledge, and self-rated competence in, and preparedness for, managing first-trimester abortion complications. Results Resident learners (N = 26) represented all four classes of OB/GYN residents. Residents initially showed stronger clinical knowledge in managing postabortal hemorrhage than sepsis (90% vs. 62%, p < .001). Clinical knowledge improved following the sepsis simulation (62% to 91%, p < .001), and remained strong but unchanged after the hemorrhage simulation (90% to 87%, p = .3). Resident self-assessments of competence and preparedness were significantly improved after both the hemorrhage (p = .006) and sepsis (p = .002) simulations. Learners reported that the simulation increased their level of comfort in managing these complications in their future practice. Discussion Postabortal hemorrhage and sepsis simulations increased OB/GYN residents' knowledge, comfort, and preparedness for managing rare complications of first-trimester abortions. In-vivo simulation and interdepartmental collaboration were novel aspects of these simulations that may facilitate increased preparedness and management skills.
format	article
author	Armide Storey Katharine White Kelly Treder Elisabeth Woodhams Shannon Bell Rachel Cannon
author_facet	Armide Storey Katharine White Kelly Treder Elisabeth Woodhams Shannon Bell Rachel Cannon
author_sort	Armide Storey
title	First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage
title_short	First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage
title_full	First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage
title_fullStr	First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage
title_full_unstemmed	First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage
title_sort	first-trimester abortion complications: simulation cases for ob/gyn residents in sepsis and hemorrhage
publisher	Association of American Medical Colleges
publishDate	2020
url	https://doaj.org/article/f9b01ee4617b418e9a81a794a75370e3
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First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage

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