Abstract：
OBJECTIVE: The aims of this study were to assess whether a regional simulation-based training course in external cephalic version (ECV) would lead to the adoption of this technique in hospitals where it was not previously practiced, and to improve success rates in those already performing it.
METHODS: This was an intervention study where two specialists in obstetrics and gynecology from 10 Portuguese public maternity hospitals attended a structured simulation-based training in ECV. Hospitals were categorized based on whether ECV was conducted prior to the training program, and on their annual number of deliveries. Main outcomes were the number of ECVs performed in the 2 years before and after the course, and their success rates.
RESULTS: Implementation of ECV was achieved in four additional hospitals during the 2 years following the course. Among the three hospitals already performing ECV and able to report their data, no significant differences in success rates were observed in the 2 years following the course (45.6% vs. 47.9%, P = 0.797). After a successful ECV, 77.7% of women had a vaginal delivery.
CONCLUSIONS: A regional simulation-based training course in ECV led to an increase in the number of hospitals implementing the technique in the subsequent 2 years, but it did not impact the success rates in centers where it was already performed. This study highlights the potential of simulation-based courses in ECV, as well as the need to improve patients´ access to the technique and to centralize ECV services at a regional level.
METHODS: This was an intervention study where two specialists in obstetrics and gynecology from 10 Portuguese public maternity hospitals attended a structured simulation-based training in ECV. Hospitals were categorized based on whether ECV was conducted prior to the training program, and on their annual number of deliveries. Main outcomes were the number of ECVs performed in the 2 years before and after the course, and their success rates.
RESULTS: Implementation of ECV was achieved in four additional hospitals during the 2 years following the course. Among the three hospitals already performing ECV and able to report their data, no significant differences in success rates were observed in the 2 years following the course (45.6% vs. 47.9%, P = 0.797). After a successful ECV, 77.7% of women had a vaginal delivery.
CONCLUSIONS: A regional simulation-based training course in ECV led to an increase in the number of hospitals implementing the technique in the subsequent 2 years, but it did not impact the success rates in centers where it was already performed. This study highlights the potential of simulation-based courses in ECV, as well as the need to improve patients´ access to the technique and to centralize ECV services at a regional level.
摘要：
目的：本研究的目的是评估外部头颅版本（ECV）的基于区域模拟的培训课程是否会导致在以前没有实践过的医院中采用这种技术，并提高那些已经执行它的成功率。
方法：这是一项干预研究，来自10家葡萄牙公立妇产医院的两名妇产科专家参加了基于模拟的ECV结构化培训。根据培训计划之前是否进行了ECV，对医院进行了分类。以及他们每年交付的数量。主要结果是课程前后2年内进行的ECV数量，和他们的成功率。
结果：在课程结束后的2年内，另外四家医院实现了ECV的实施。在已经进行ECV并能够报告其数据的三家医院中，在课程后的2年内，成功率没有观察到显著差异(45.6%与47.9%,P=0.797)。ECV成功后,77.7％的妇女阴道分娩。
结论：在ECV中进行的基于区域模拟的培训课程导致在随后的两年中实施该技术的医院数量增加，但这并不影响已经实施的中心的成功率。这项研究强调了ECV中基于模拟的课程的潜力，以及需要改善患者对该技术的访问并在区域一级集中ECV服务。
方法：这是一项干预研究，来自10家葡萄牙公立妇产医院的两名妇产科专家参加了基于模拟的ECV结构化培训。根据培训计划之前是否进行了ECV，对医院进行了分类。以及他们每年交付的数量。主要结果是课程前后2年内进行的ECV数量，和他们的成功率。
结果：在课程结束后的2年内，另外四家医院实现了ECV的实施。在已经进行ECV并能够报告其数据的三家医院中，在课程后的2年内，成功率没有观察到显著差异(45.6%与47.9%,P=0.797)。ECV成功后,77.7％的妇女阴道分娩。
结论：在ECV中进行的基于区域模拟的培训课程导致在随后的两年中实施该技术的医院数量增加，但这并不影响已经实施的中心的成功率。这项研究强调了ECV中基于模拟的课程的潜力，以及需要改善患者对该技术的访问并在区域一级集中ECV服务。
