Are residents confident to manage shoulder dystocia?

Abstract

Background: Data are lacking to determine whether residents are confident in independently managing shoulder dystocia, as the ACGME does not track this condition.Objective: A 25-question web-based survey was electronically disseminated to program directors of all 243 accredited OB/GYN residency programs in the United States. The survey was sent weekly over a four week period to encourage completion, through April and May of 2018. A Likert scale was used to assess U.S. obstetric and gynecology residents clinical and didactic training experience related to shoulder dystocia. Survey monkey and IBM SPSS Statistics were used to analyze the responses. Results: Nearly all (97%) of the 116 (total of 5,493) residents who responded (2%) had received formal lecture or simulation training (87%), and most (89%) felt that they had received appropriate didactic training. 64% of residents had participated in < 10 total cases of shoulder dystocia. Only 51.7% and 48.3% agreed that they could currently independently perform delivery of the posterior fetal arm and fetal rotational maneuvers, respectively. Approximately half of the residents (47%) responded that they had never independently managed a shoulder dystocia from start to finish. After completion of residency training, 34.5% and 52.6% strongly agreed or agreed, respectively, that they would feel comfortable independently managing a shoulder dystocia. Conclusions: Graduating obstetric residents do not appear to be confident to independently manage shoulder dystocia.