Standardising Simulation‐Based Obstetric Emergency Training: A Delphi Consensus Study
Mannella Paolo, Benedetto Chiara, Canuto Emilie, Carducci Brigida, Carbone Ilma Floriana, Cesari Elena, Cetin Irene, Ciavattini Andrea, Colacurci Nicola, Cromi Antonella, Driul Lorenza, Di Simone Nicoletta, Ferrazzani Sergio, Frusca Tiziana, Garofalo Serafina, Ghi Tullio, Giardini Valentina, Greco Pantaleo, Inversetti Annalisa, Lanzone Antonio, Marozio Luca, Martino Carmelinda, Mecacci Federico, Morlando Maddalena, Neri Caterina, Pilu Gianluigi, Prefumo Federico, Rizzo Giuseppe, Scambia Giovanni, Simoncini Tommaso, Taricco Emanuela, Vergani Patrizia, Zaina Barbara, Nappi E. RossellaABSTRACT
Objective
To develop standardised Objective Structured Assessment of Technical Skills (OSATS) forms for major obstetric emergencies, thereby improving the quality and consistency of obstetric simulation training.
Design and Setting
A panel of national experts with extensive experience in teaching Gynaecology and Obstetrics, simulation training, and the clinical management of labour complications and peripartum emergencies.
Population and Methods
A Delphi process with four iterative rounds was conducted to create, evaluate, revise, and finalise OSATS checklists for 11 obstetric emergencies. Each OSATS form was rated using a Likert scale (0–9), refined according to expert feedback, and validated through structured discussions.
Main Outcome Measures
The creation and approval of OSATS forms for shoulder dystocia, vacuum delivery, assisted breech delivery, third‐ and fourth‐degree laceration repair, external cephalic version, abnormal CTG management, postpartum haemorrhage, non‐cephalic second twin delivery, reverse breech extraction at caesarean section, maternal collapse and forceps application.
Results
Consensus was achieved for all emergencies with good to excellent ratings: shoulder dystocia (82%), external cephalic version (94%), vacuum delivery (75%), abnormal CTG management (42%), postpartum haemorrhage (96%), reverse breech extraction (72%), maternal collapse (94%), forceps application (76%), non‐cephalic second twin delivery (96%), assisted breech delivery (94%) and third‐ and fourth‐degree laceration repair (82%).
Conclusion
The Delphi study successfully developed consensus‐based OSATS forms, addressing the need for standardised assessments in obstetric simulation training. These tools enhance training quality, identify skill gaps and improve clinical preparedness. This study was supported by AGUI (Associazione Ginecologi Universitari Italiani).