{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:09:16Z","timestamp":1785841756100,"version":"3.56.0"},"reference-count":27,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2019-0216_s_999_w2aab3b7c36b1b6b1aab1c17b1Aa\">\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although cesarean sections at full dilatation are increasing, training in delivering a deeply impacted fetal head is lacking among obstetricians. The purpose of the study was to implement and evaluate a theoretical and simulation-based training program for this obstetrical emergency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2019-0216_s_998_w2aab3b7c36b1b6b1aab1c17b2Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed a training program consisting of a theoretical introduction presenting a clinical algorithm, developed on the basis of the available literature, followed by a simulation session. We used the Kirkpatrick\u2019s framework to evaluate the program. A questionnaire was distributed, directly before, immediately and 6 weeks after the training. Self-perceived competencies were evaluated on a 6-point Likert scale. Pre- and post-test differences in the Likert scale were measured with the Wilcoxon signed rank test. Additionally, the training sessions were video recorded and rated with a checklist in relation to how well the algorithm was followed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2019-0216_s_997_w2aab3b7c36b1b6b1aab1c17b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eleven residents and eight senior physicians took part to the training. More than 40% of participants experienced a comparable situation after the course during clinical work. Their knowledge and self-perceived competencies improved immediately after the training program and 6 weeks later. Major improvements were seen in the awareness of the algorithm and in the confidence in performing the reverse breech extraction (14.3% of the participants felt confident with the maneuver in the pre-training assessment compared with 66.7% 6 week post-training).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2019-0216_s_996_w2aab3b7c36b1b6b1aab1c17b4Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our theoretical and simulation-based training program was successful in improving knowledge and confidence of the participants in delivering a deeply impacted fetal head during a cesarean section performed at full dilation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2019-0216","type":"journal-article","created":{"date-parts":[[2019,9,8]],"date-time":"2019-09-08T09:02:30Z","timestamp":1567933350000},"page":"857-866","source":"Crossref","is-referenced-by-count":11,"title":["Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program"],"prefix":"10.1515","volume":"47","author":[{"given":"C\u00e9cile","family":"Monod","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics , University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Buechel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics , University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Gisin","sequence":"additional","affiliation":[{"name":"Department of Anesthesia , University Hospital Basel and Simulation Center SimBa , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha","family":"Abo El Ela","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics , University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah R.","family":"Vogt","sequence":"additional","affiliation":[{"name":"Clinical Trial Unit, Department Clinical Research , University Hospital Basel and University Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Hoesli","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics , University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2019,9,7]]},"reference":[{"key":"2021021322421547822_j_jpm-2019-0216_ref_001_w2aab3b7c36b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Loudon JA, Groom KM, Hinkson L, Harrington D, Paterson-BrownS. Changing trends in operative delivery performed at full dilatation over a 10-year period. J Obstet Gynaecol 2010;30:370\u20135.","DOI":"10.3109\/01443611003628411"},{"key":"2021021322421547822_j_jpm-2019-0216_ref_002_w2aab3b7c36b1b6b1ab2b2b2Aa","doi-asserted-by":"crossref","unstructured":"Unterscheider J, McMenamin M, Cullinane F. Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend. Eur J Obstet Gynecol Reprod Biol 2011;157:141\u20134.","DOI":"10.1016\/j.ejogrb.2011.03.008"},{"key":"2021021322421547822_j_jpm-2019-0216_ref_003_w2aab3b7c36b1b6b1ab2b2b3Aa","doi-asserted-by":"crossref","unstructured":"Manning JB, Tolcher MC, Chandraharan E, Rose CH. Delivery of an impacted fetal head during cesarean: a literature review and proposed management algorithm. 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