Karachi, May 14, 2019 (PPI-OT): Nursing student Haseeb Ahmed* has never been inside a delivery room and he’s never been this close to a ‘live birth’. This is going to be his very first delivery.
A series of beeps and blips from the three monitors around him tell him everything is fine, for now. He casts a glance to the cardiotocography machine (CTG) to the right of the patient, Victoria. The machine displays the baby’s heart rate and traces out a pattern of crests and troughs indicating the frequency and duration of the mother’s contractions.
Everything seems in order until Victoria starts to complain of abdominal pain. A hill appears on the CTG machine. Haseeb asks how strong the pain is and notices that Victoria is breathing harder, crying out and grimacing. He places his hand on the patient’s stomach to sense whether it’s hard or soft.
And then Haseeb freezes as he tries to remember what to do next. The assistant nurse, Haider, spots his hesitation and asks him if it’s time to examine dilation.
On the other side of the delivery room, behind a mirror, an instructor notes that Haseeb examined the abdomen without washing his hands. She also observes that Haseeb forgot to ask Victoria to use deep breathing techniques for pain relief during labour. Both points are added to the training session’s video recording in the simulated delivery room of the Centre for Innovation in Medical Education (CIME).
Haseeb is among the first nurses to benefit from training on Victoria, the CIME’s high-fidelity birth simulator, which enables students to apply their knowledge, practice essential skills and become more confident in handling pregnant patients in a low stakes, risk-free environment.
The Victoria simulator, the only such simulator in the country, represents the only way male nurses can gain practical experience in the compulsory maternal and reproductive health component of their degrees. Cultural considerations, the need to ensure a patient’s privacy and concerns about trainees being around an anxious patient mean that male nurses aren’t allowed in labour rooms or delivery wards in Pakistan.
“The most valuable learning on the simulator occurs when students make mistakes,” says Sadia Abbas, a senior instructor and simulation expert in midwifery at AKU. She explains that students are shown a video recording of their session straight after they finish enabling them to reflect on how they can improve and to perfect their skills through repetition.
Female nurses do not face the same barriers as male students who have to rely on case studies, textbook knowledge and role play with fellow students to understand the complexities of child birth putting them at a disadvantage.
“Students, both male and female, learn better at their own pace and the Victoria simulator gives us the flexibility to create a range of situations they’ll face in their working lives,” Mrs Abbas adds.
Victoria enables nursing students gain exposure to normal births but it can also replicate a range of complications from complex birth scenarios such as premature deliveries, and even situations that endanger the lives of both a mother and her child including shoulder dystocia and excessive bleeding after birth. Better still, these scenarios can be played out in a multi-disciplinary way which enables doctors and nurses to practice working in teams in high pressure situations.
“We can manage over 200 ‘child births’ a year thanks to Victoria. This helps us address a significant gap in the education of male students and midwives,” states CIME Director Charles Docherty. “We’re already working on making courses using the Victoria simulator available to students and healthcare professionals at other universities and teaching hospitals and we look forward to sharing the educational advantage it provides with all practitioners in the field.”
For more information, contact:
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Aga Khan University (AKU)
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