Conquering maternal mortality: skill development in medical curriculum
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20160386Keywords:
Skill development, Teaching tool, Conduct of labor, Maternal mortality, Medical CurriculumAbstract
Background: Maternal Mortality Rate remains to be high in developing countries despite the advances made in the modern world. A medical student needs to understand the basic clinical subjects and in a short span of one year translate it into patient care. A skill development method was initiated in the final year curriculum of medical students to integrate the basic knowledge of labor with the final outcome of reducing maternal mortality rate.
Methods: The skills were demonstrated on mannequins and simulation models of difficult situations in labour were provided. The study was conducted in Saveetha Medical College in the Department of Obstetrics and Gynaecology in May 2015 as a one day hands on workshop for medical undergraduate students. One hundred and fourteen medical students conducted normal labor, applied forceps and ventouse, sutured episiotomies and perineal tear and performed a drill on active management of third stage of labor on training mannequins. All the basic didactic teaching and its translation into clinical skills were tested pertaining to the problem of parturition. Plenary discussion of each demonstrable skill was done by a galaxy of experts. This was followed with Mind Mapping of concepts developed. Pretest and posttest helped the teaching faculty to assess the impact of knowledge generated. Feedback was obtained to improvise the existing teaching method and develop new teaching tools.
Results: The students were able to comprehend Conduct of Labor from its basics and decide on the relevant clinical implications. The case based skill demonstrations done on instrumental delivery, episiotomy suturing, clinical pelvimetry, active management of third stage of labor and monitoring of labor using partogram gave students hands on experience and improved their practical knowledge.
Conclusion: Skill Development in conduct of labour helps medical students to understand the clinical implications better. A well trained medical student can thus help to reduce maternal mortality rate in developing countries.
References
Mudaliar AL, Menon MK. Maternal mortality .In: Mudaliar and Menon’s Clinical Obstetrics .Eleventh Ed. Delhi. Universities Press (India) Private Limited. 2011.441-6.
LaleSay, Chou D, Gemmill A, Tuncalp O, Ann-Beth Moller, Daniels J. Global causes of maternal death : A WHO systematic analysis. The Lancet. 20142(6):323-34.
Trends in Maternal Mortality. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. 1990 to 2013. Available at www.who.int
Fernandez R, Parker D, Kalus JS, Miller D, Pharm D, Compton S. Using a human patient simulation mannequin to teach interdisciplinary Team Skills to pharmacy students. Am J Pharm Educ. 2007;71(3):51.
Gordon JA, Wilkerson WM, Shaffer DW, Armstong EG. “Practicing” Medicine without risk: Students and educators responses to high fidelity patient simulation, Medicineacademic, Educating physicians research reports. 2011;76(5):469-72,
Okuda Y, Bryson EO, DeMaria S, Jacobson L, Quinones J, Shen B, et al. The Utility of Simulation in Medical Education: What Is the Evidence? Mt Sinai J Med. 2009;76:330-43.
MacDowall j. The assessment and treatment of the acutely ill patient - the role of the patient simulator as a teaching tool in the undergraduate programme, Medical Teacher. 2006;28(4):326-9.
Schoening AM, Barbara SJ, Martha TJ. Simulated clinical experience. Nursing students perceptions and the educators’ role, Nurse educator. 2006;31(6):253-8.
Maruo T. Undergraduate and post graduate education clinical education in Kobe University of Medicine. Kobe J Med Sci.,1997;43(6):237-42.
Margolis CZ, Deckelbaum RJ, Henkin Y, Baram S, Cooper P, Alkan ML. A medical school for international health run by international partners. Acad Med. 2004;79(8):744-51.
Wijnen-Meijer M, Cate OT, Rademakers JJ, Van Der Schaaf M, Borleffs JC. The Influence of a vertically integrated curriculum on the transition to postgraduate training. Med Teach. 2009;31(11):e528-32.
Wijnen-Meijer M, ten Cate O, van der Schaaf M, Harendza S. Graduates from vertically integrated curricula. Clin Teach. 2013;10(3):155-9.
United Nations 2015 Millennium Development Goals Report. 2015. Available from http://www.un.org/millenniumgoals/reports.shtml. Assessed 1 December 2015.
