Simulation Modalities for Obstetrics and Gynecology

  • Erin Higgins
  • Tamika C. Auguste
Part of the Comprehensive Healthcare Simulation book series (CHS)


Various simulation modalities exist for healthcare training, many of which can be applied to the field of obstetrics and gynecology. From low-fidelity box trainers to highly sophisticated mannequins and robotic trainers, learners can benefit from a wide range of teaching approaches, and these modalities can be used at all levels of training. Combining certain trainers into a hybrid model allows instructors to utilize the most beneficial aspects of distinct modalities to provide a better teaching environment. Despite the successes in decreasing medical errors and improving teamwork and communication, simulation remains difficult to implement on a global scale due to barriers including cost and protected time for learners and instructors.


Simulator – a generic term that refers to a physical object, device, situation, or environment where a task or series of tasks can be realistically or dynamically represented Low-fidelity simulator – a simplistic training model that is used for practicing motor skills and tasks High-fidelity simulator – a life-like trainer that allows motor skill enhancement in a real-world environment Part-task trainer – a simulator that replicates a body part or internal organ Model-driven simulator – a full-size mannequin that resembles a human being and can respond physiologically to medical interventions Virtual reality simulator – a computer-based simulator with a handpiece designed to recreate a 3D, real-world environment Haptic simulator – an augmented virtual reality simulator that facilitates various sensory and tactile aspects of real-world experience 


  1. 1.
    Daniels K, Auguste T. Moving forward in patient safety: multidisciplinary team training. Semin Perinatol. 2013;37(3):146–50.CrossRefGoogle Scholar
  2. 2.
    Levine A, De Maria S Jr, Schwartz A, Sim A. The comprehensive textbook of healthcare simulation. New York: Springer; 2014. Print.Google Scholar
  3. 3.
    Deering S, Auguste T, Lockrow E. Obstetric simulation for medical student, resident, and fellow education. Semin Perinatol. 2013;37(3):143–5.CrossRefGoogle Scholar
  4. 4.
    Macedonia CR, Gherman RB, Satin AJ. Simulation laboratories for training in obstetrics and gynecology. Obstet Gynecol. 2003;102:388–92.PubMedGoogle Scholar
  5. 5.
    Deering SH, Hodor J, Wylen M, Poggi S, Nielsen P, Satin AJ. Additional training with an obstetric simulator improves medical student comfort with basic procedures. Simul Healthc. 2006;1(1):32–4.CrossRefGoogle Scholar
  6. 6.
    Jude DC, Gilbert GG, Magrane D. Simulation training in the obstetrics and gynecology clerkship. Am J Obstet Gynecol. 2006;195(5):1489–92. Epub 2006 Jul 17.CrossRefGoogle Scholar
  7. 7.
    Nitsche JF, Shumard KM, Fino NF, Denney JM, Quinn KH, Bailey JC, Jijon R, Huang C, Kesty K, Whitecar PW, Grandis AS, Brost BC. Effectiveness of labor cervical examination simulation in medical student education. Obstet Gynecol. 2015;126(Suppl 4):13S–20S.CrossRefGoogle Scholar
  8. 8.
    Dayal AK, Fisher N, Magrane D, Goffman D, Bernstein PS, Katz NT. Simulation training improves medical students’ learning experiences when performing real vaginal deliveries. Simul Healthc. 2009;4(3):155–9.CrossRefGoogle Scholar
  9. 9.
    Scholz C, Mann C, Kopp V, Kost B, Kainer F, Fischer MR. High-fidelity simulation increases obstetric self-assurance and skills in undergraduate medical students. J Perinat Med. 2012;40(6):607–13.CrossRefGoogle Scholar
  10. 10.
    Fisher N, Bernstein PS, Satin A, Pardanani S, Heo H, Merkatz IR, Goffman D. Resident training for eclampsia and magnesium toxicity management: simulation or traditional lecture? Am J Obstet Gynecol. 2010;203(4):379.e1–5. Epub 2010 Aug 5.CrossRefGoogle Scholar
  11. 11.
    Deering S, Poggi S, Macedonia C, Gherman R, Satin AJ. Improving resident competency in the management of shoulder dystocia with simulation training. Obstet Gynecol. 2004;103:1224–8.CrossRefGoogle Scholar
  12. 12.
    Kiely DJ, Stephanson K, Ross S. Assessing image quality of low-cost laparoscopic box trainers: options for residents training at home. Simul Healthc. 2011;6(5):292–8.CrossRefGoogle Scholar
  13. 13.
    Winkel AF, Gillespie C, Uquillas K, Zabar S, Szyld D. Assessment of developmental progress using an objective structured clinical examination-simulation hybrid examination for obstetrics and gynecology residents. J Surg Educ. 2016;73(2):230–7.CrossRefGoogle Scholar
  14. 14.
    Chang E. The role of simulation training in obstetrics: a healthcare training strategy dedicated to performance improvement. Curr Opin Obstet Gynecol. 2013;25(6):482–6.CrossRefGoogle Scholar
  15. 15.
    Draycott TJ, Crofts JF, Ash JP, et al. Improving neonatal outcome through practical shoulder dystocia training. Obstet Gynecol. 2008;112:14–20.CrossRefGoogle Scholar
  16. 16.
    Phipps MG, Lindquist DG, McConaughey E, et al. Outcomes from a labor and delivery team training program with simulation component. Am J Obstet Gynecol. 2012;206(1):3–9.CrossRefGoogle Scholar
  17. 17.
    Pratt S, Mann S, Salisbury M, et al. Impact of CRM-based team training in obstetric outcomes and clinician patient safety attitudes. Jt Comm J Qual Patient Saf. 2007;33:720–5.CrossRefGoogle Scholar
  18. 18.
    Newmark J, Dandolu V, Milner R, Grewal H, Harbison S, Hernandez E. Correlating virtual reality and box trainer tasks in the assessment of laparoscopic surgical skills. Am J Obstet Gynecol. 2007;197(5):546.e1–4.CrossRefGoogle Scholar
  19. 19.
    Botden SM, Torab F, Buzink SN, Jakimowicz JJ. The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation. Surg Endosc. 2008;22(5):1214–22. Epub 2007 Oct 18.CrossRefGoogle Scholar
  20. 20.
    Burden C, Oestergaard J, Larsen CR. Integration of laparoscopic virtual-reality simulation into gynaecology training. BJOG. 2011;118(Suppl 3):5–10.CrossRefGoogle Scholar
  21. 21.
    Larsen CR, Soerensen JL, Grantcharov TP, Dalsgaard T, Schouenborg L, Ottosen C, et al. Effect of virtual reality training on laparoscopic surgery: randomised controlled trial. BMJ. 2009;338:61802.CrossRefGoogle Scholar
  22. 22.
    Gurusamy KS, Aggarwal R, Palanivelu L, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database Syst Rev. 2009;1:CD006575.Google Scholar
  23. 23.
    Ballantyne GH, Moll F. The da Vinci telerobotic surgical system: the virtual operative field and the telepresence surgery. Surg Clin N Am. 2003;83(6):1293–304.CrossRefGoogle Scholar
  24. 24.
    Schreuder HW, Wolswijk R, Zweemer RP, Schijven MP, Verheijen RH. Training and learning robotic surgery, time for a more structured approach: a systematic review. BJOG. 2012;119(2):137–49. Epub 2011 Oct 10.CrossRefPubMedGoogle Scholar
  25. 25.
    Nitsche JF, Brost BC. A cervical cerclage task trainer for maternal-fetal medicine fellows and obstetrics/gynecology residents. Simul Healthc. 2012;7(5):321–5.CrossRefGoogle Scholar
  26. 26.
    Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington, DC: Institute of Medicine (US) Committee on Quality of Health Care in America/ National Academies Press (US); 2000.Google Scholar
  27. 27.
    Eppich W, Howard V, Vozenilek J, Curran I. Simulation-based team training in healthcare. Simul Healthc. 2011;6(Suppl):S14–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Erin Higgins
    • 1
  • Tamika C. Auguste
    • 2
  1. 1.Department of Obstetrics and GynecologyCleveland ClinicClevelandUSA
  2. 2.Department of Obstetrics and Gynecology, MedStar Washington Hospital CenterWashington, DCUSA

Personalised recommendations