Shoulder Dystocia and Neonatal Resuscitation: An Integrated Obstetrics and Neonatology Simulation Case for Medical Students

Publication ID Published Volume
10594 June 15, 2017 13

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Introduction: The new model in medical education of longitudinal clinical clerkships can be complemented by high-technology simulation, which provides a safe space for learners to consolidate clinical knowledge and practice decision-making skills, teamwork, and communication. We developed an interdisciplinary training intervention including a simulation case and structured debriefing to link clinical content between pediatrics and obstetrics at a major academic medical center. Methods: In this case, a 38-year-old female at 38 weeks gestation presents with onset of labor complicated by shoulder dystocia. After the appropriate maneuvers, a depressed neonate is delivered and requires resuscitation. Major equipment needed includes a high- or low-technology birthing mannequin and an infant mannequin. Results: Fifty-four third-year medical students participated in this simulation-based intervention at the completion of their integrated pediatrics and obstetrics clerkship. Ninety-one percent of students agreed that the shoulder dystocia simulation was designed appropriately for their learning level and enhanced their ability to handle a risky delivery. Ninety-four percent agreed that the neonatal resuscitation simulation was designed appropriately for their learning level, and 89% reported an enhanced ability to handle a similar situation in the clinic following the intervention. The average overall ratings were 4.24 (SD = 0.61) and 4.06 (SD = 0.89) on a 5-point scale (1 = poor, 5 = excellent) for the obstetrics and pediatrics simulations, respectively. Discussion: The integrated obstetrics and pediatrics scenario is feasible to run and clinically accurate. Two distinct areas of medicine in the third-year curriculum are logically incorporated into one cohesive simulation-based training intervention that students found positive and realistic.


Alphonso A, Pathy S, Bruno C, et al. Shoulder dystocia and neonatal resuscitation: an integrated obstetrics and neonatology simulation case for medical students. MedEdPORTAL Publications. 2017;13:10594.

Educational Objectives

By the end of this simulation, learners will be able to:

  1. Evaluate an emergent obstetric or a pediatric clinical scenario.
  2. Establish a plan to manage labor and perform delivery maneuvers in an obstetric scenario complicated by shoulder dystocia or to manage the resuscitation of a depressed newborn infant.
  3. Demonstrate communication skills with team members of similar and different disciplines.
  4. Synthesize clinical information to convey an appropriate message to a patient’s family.


  • Shoulder Dystocia, Neonatal Resuscitation, Pediatrics, OB/Gyn, Obstetrics, Gynecology, Handoffs


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