Published in:
01-08-2017 | Original Article
An international assessment of trainee experience, confidence, and comfort in operative vaginal delivery
Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2017
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Aim
The aim of this study was to assess Irish and Canadian obstetricians in training (“trainees”) experience, confidence, and comfort in performing operative vaginal delivery (OVD).
Study design
Trainees in Obstetrics and Gynaecology in the University of Toronto and the Royal College of Physicians of Ireland (RCPI) were invited to participate in an anonymous online survey reviewing experience as primary operator of OVD. Trainee confidence and comfort was self-assessed based upon their last few OVDs.
Results
The response rate was 55% amongst Canadian trainees (31/56) and 44% amongst Irish trainees (21/48). When comparing Irish with Canadian trainee experience, the median numbers of vacuum and forceps deliveries performed by Irish trainees as primary operator were reported to be higher [125 (range 10–150) vs 20 (range 5–40); p < 0.0001 (ventouse), 45 (range 10–150) vs 6 (range 1–12); p = 0.0001 (forceps)]. Despite this, trainee confidence between the groups did not differ [confidence score: 18.7 (SD 3.2) vs 17.8 (SD 3.5), p = 0.3]. There were some differences regarding comfort in certain aspects of OVD, most notably increased comfort in Irish trainees in pre-procedure assessment skills of OVD.
Conclusion
With falling OVD rates worldwide, training experience is declining. Despite higher numbers of OVD within the Irish trainee group, there was no difference in trainee confidence between the two groups. These results suggest that a high number of cases as primary operator may not be required to establish operator confidence in performing a procedure. Irish trainees self-reported more comfort in non-technical skills of OVD, suggesting a step-wise effect of experience on first technical and then non-technical skills.