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Simulation in Obstetrics

Satin, Andrew J. MD

doi: 10.1097/AOG.0000000000002682
Contents: Medical Education: Clinical Expert Series
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Simulation in obstetrics is a widely accepted and valuable tool that benefits all levels of learners from medical students to maternal–fetal medicine subspecialists. What began as an adjunct to medical education now has a rapidly expanding role in acquisition of new and innovative procedures, team and unit training, and safety and quality initiatives. The number of obstetric simulation peer-reviewed reports has increased exponentially in recent years, yet only a small percentage of reports primarily addresses clinical outcomes. Studies link simulation to a reduction in neonatal brachial plexus injury, maternal trauma related to forceps delivery, response to postpartum hemorrhage, efficiency in performing emergent cesarean delivery, and neonatal mortality. Simulation is a required component in accredited obstetrics and gynecology residency training programs. Obstetric simulation has a role in the certification of physicians, and simulation hands-on courses may be used to meet maintenance of certification requirements. As simulation platforms are validated, they are likely to be incorporated into the certification process as a means of assessing technical and communication skills. Accrediting, certifying, professional, quality, and safety organizations have invested in simulation committees, interest groups, curricula, and continuing medical education courses. Support for research, including large multicenter trials, are needed to inform further implementation. Research and development should lead to lower costs and improved simulators. As the public, government, licensing, and credentialing institutions explore means of improving patient safety, expansion of simulation in obstetrics is inevitable.

Simulation benefits all levels of obstetric learners, and its effects on improving patient outcomes, quality and safety, and accreditation and certification are growing.

Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, Maryland.

Corresponding author: Andrew J. Satin, MD, Department of Gynecology and Obstetrics, 600 N Wolfe Street, Phipps 264, Baltimore, MD 21287-1264; email:

Financial Disclosure The author did not report any potential conflicts of interest.

The author is an employee of Johns Hopkins University and a Director and President-Elect of the American Board of Obstetrics and Gynecology.

The opinions expressed are those of the author and not that of the organizations he serves.

Continuing medical education for this article is available at

The author has indicated that he has met the journal's requirements for authorship.

Received November 13, 2017. Received in revised form February 10, 2018. Accepted February 15, 2018.

© 2018 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.