1. Using Simulation to Teach Obstetrics to Second Year Medical Students Catherine Pokropek, MD; David Cameron, MD; Judith Venuti, PhD; Dotun Ogunyemi, MD Department of Obstetrics and Gynecology ■ Oakland University William Beaumont Hospital, Royal Oak, MI Background Simulation training can teach learners valuable skills. Reproduces clinical conditions that allows novices to practice and hone skills in a risk-free environment. Enables learners to approach clinical scenarios with more confidence, creating an atmosphere that puts patients at ease Improves patient safety and decreases medical errors. Simulation may facilitate bridging classroom/clinical threshold a year earlier by practicing concepts before first interactions with patients. Objectives To assess the knowledge retention, attitudes and perception of 2nd year medical students of a mandatory course on labor and delivery simulation at the Surgical Learning Center. Procedures: Students in groups of 3-4 rotated for 20 minutes, in 3 stations: 1) Simulated vaginal delivery; each student delivering a baby 2) Interactive review of fetal heart rate patterns 3) Cervical dilation assessment using a “blinded” & “open” cervical models Debriefing session to answer questions & clarify conceptions. Surveys: Students completed the following surveys before, after and 4 months after the curriculum : 1) Knowledge (6 questions, maximum score 15) 2) Attitude ( 4 questions, range 1-5), Survey below only after and 4 months after the curriculum : 1)Perception (18 questions, range 1-10) A Simulation Learning Center technical assessment survey (8 questions, range 1-4) at the end of the simulation. The mean Liekart scores of the pre and post satisfaction survey scores were compared using t test A p value of <0.05 was taken as significant. Results 105 students participated in the curriculum, 95 completed pre & immediate post simulation survey; 56 completed 4 month post survey. Knowledge survey students showed increase in knowledge from pre to post simulation: 12.82 + 6.02 versus 29.57+ 5.15 (p<0.001) Attitude questions, showed increase in comfort level of students from pre to post simulation: 2.43 + 1.18 to 4.19+1.21(p<0.001). For the technical assessments, the mean scores ranged from 3.37-3.95. Perception score from post curriculum to 4 months dropped slightly: 9.05+0.99 to 8.43+1.3,( p=0.001 ). Both attitude and Knowledge scores were still significantly increased at 6 months compared to pre-simulation but decreased from the immediate post scores Conclusions Figure 4. Photographs of each simulation station Results of the Knowledge Questionnaire Disclosure : No disclosures to report. This study was approved by Beaumont Health System Institutional Review Board  It is possible to introduce a structured, comprehensive obstetrical simulation to pre-clinical 2nd year med students  The course improved students’ short term and knowledge and comfort with some long-term persistence  Simulation training can build confidence in the learners' ability to perform tasks which cannot be learned in a didactic setting  There is attrition of perception after time following a single simulation curriculum  We are developing an ongoing interactive educational process to enable the students to retain knowledge and perception  Potential to carry this through during clinical years, and for 4 th year medical students who plan on pursuing OBGYN Results of Student Feedback Written comments were analyzed “What went well”: 86% positive, 14% blank, 0 negative 74% felt improvement was required The majority commented on time constraints Only 3% felt anything should be discarded; over 60% stated nothing needs to be changed. Results of the Attitude Survey Results of the SLC Technical Assessment. Methods All second year OUWB medical students participated in December 2014. Week prior, students received lecture on intra-partum obstetrics Curriculum occurred over 2 days Students were divided into groups of 9 Orientation at beginning of the curriculum TopicPre-Survey Mean (SD) N= 95 Post-Survey Mean (SD) N=95 Mean Differenc e SigCI Category I tracing Baseline 0.85 (.35)0.99 (.10)0.130.000 -3.8 - -2.9 Fetal head flexion occurs after crowning 0.65 (.48)0.72 (.45)0.060.352 -.19 – 0.70 Zero station head is at pelvic brim 0.38 (.05)0.68 (.46)0.310.000 -.44 - -.17 Stage IV is delivery of placenta 0.36 (.48)0.76 (.43)0.400.000 -.53 - -.27 Normal fetal position in labor 0.053 (.21)0.47 (.47)0.410.000 -.54 - -.35 Cat III FHT0.132(.30)0.57 (.32)0.440.000 -.52- -.31 TopicPreSurvey Mean (SD) N= 95 Post Survey Mean (SD) N=95 Mean Differ ence Sigci Can describe stages of labor 3.71 (2.15)7.49 (1.47)-3.790.000 -4.3- - 3.26 Comfortable with cervical examination 2.96 (1.66)7.31 (1.49)-4.340.000 -4.8 - - 3.9 Comfort with looking at and interpreting FHT 2.3 (1.6)7.57(1.5)-5.260.000 -5.7 – 4.8 Describe mechanism of labor 3.94(1.93)7.28(1.3)-3.340.000 -3.8 - - 2.86 TopicMean (SD) Objectives Communicated3.37 (.61) Objectives Achieved3.71 (.46) Teaching methods3.86 (.35) Instructors Knowledge3.95 (.23) Clinical content3.84(.37) Realistic3.85 (.36) Right Equipment3.88 (.33) Application of Knowledge3.61 (.56) ScoresPre-simulation6 months post simulation P value Attitude total scores 12.82(6.02)20.0 (7.46)0.000 Knowledge total scores2.43(1.12)3.08 (1.2) -4.34 Immediate post simulation 6 months post- simulation Attitude scores29.57(5.15)20.0 (7.46)0.000 Knowledge scores4.19 (1.2)3.08 (1.2)0.000 6 months Attitude & Knowledge scores comparisons