Stanford doctors provide simulation-based training for managing obstetrical emergencies in Costa Rica

The difference in maternal mortality in developed versus developing countries has long been cited as the “largest discrepancy of all public health statistics”.1 In fact, developing regions accounted for 99 percent of the global maternal deaths in 2015.2 Maternal deaths are clustered around labor, delivery, and the immediate postpartum period,3 yet historically the majority of support for improving maternal health in the developing world has targeted pre-hospital providers of care (i.e. birth attendants and midwives). Few endeavors have directly focused on training future physicians in low-resource settings. GO MOMS (Global Outreach Mobile Obstetrics Medical Simulation) aims to reduce the burden of maternal morbidity and mortality in the developing world feasibly and sustainably by identifying knowledge gaps and providing tailored training to close these gaps.

GO MOMS recently attended the Annual National Obstetrical and Gynecologic Congress of Costa Rica where they provided training to over 70 attending physicians, residents, and nurses. Simulations focused on postpartum hemorrhage management, preeclampsia/ eclampsia management, shoulder dystocia, and full team labor and delivery simulation.

Drs. Daniels, Brodzinsky, Nino, Bianco, and Foeller, along with Senior Simulation Specialist Julie Arafeh, Stanford med student Anita Chanana, and University of Florida undergrad Diana Sanchez at the 2018 Annual National Obstetrical and Gynecologic Congress of Costa Rica

Simulation-based training for educating health professionals has consistently been found to improve knowledge, skills, behaviors, and patient-related outcomes.4 It’s especially helpful in low-resource settings given that it does not require expensive resources beyond human capital to facilitate scenarios. By acting in simulations, physicians and nurses practice not only medical techniques but also analyze their abilities to communicate effectively and work in teams while under pressure, enabling them to confidently provide better and safer care to women. The knowledge exchange works both ways, as we receive tremendous feedback from the audience and our residents and fellows gain exposure to different ways of practicing medicine. Endorsed by The American College of Obstetricians and Gynecologists’ Office of Global Women’s Health, GO MOMS plans to continue their work with simulation based training next in Guatemala.

  1. Mahler H. The safe motherhood initiative: a call to action. The Lancet. 1987 Mar 21;329(8534):668.
  2. World Health Organization. Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: executive summary.
  3. Ronsmans C, Graham WJ, Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. The lancet. 2006 Oct 6;368(9542):1189-200.
  4. Cook DA, Hatala R, Brydges R, Zendejas B, Szostek JH, Wang AT, Erwin PJ, Hamstra SJ. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. Jama. 2011 Sep 7;306(9):978-88.