R01HD107451
Project Grant
Overview
Grant Description
Simulation for Attending Obstetricians to Improve Technical Skills for Managing Postpartum Hemorrhage
Postpartum hemorrhage (PPH) is a rare but potentially catastrophic obstetric emergency and a leading cause of severe maternal morbidity and preventable mortality in the U.S. Women of racial and ethnic minority groups and those living in underserved and remote areas are at the greatest risk. Obstetric units must be prepared to manage PPH, and obstetric (OB) attendings must maintain the technical skills necessary to control PPH. To address this, simulation is a promising approach.
Obstetric simulation has shown effectiveness for team-based training, yet there is compelling evidence for the use of simulation to improve technical skills. Furthermore, prior studies and simulation research from other surgical specialties demonstrate the high likelihood of successfully validating an existing high-fidelity simulator and establishing its effectiveness in training OB attendings in the technical skills needed to manage PPH. However, a simulation program directed at OB attendings who work in varied hospital settings across the country is subject to known obstacles for implementing and spreading simulation.
We propose a staged, multicenter study to establish simulation, using innovative approaches to mitigate barriers, as an effective means for training OB attendings in three technical skills demonstrated as effective for controlling PPH: Bakri balloon placement, B-Lynch suture placement, and O'Leary suture placement. OB attendings will be assessed at baseline, mentored, and re-assessed. The primary outcomes will be the change in assessment scores (measured by validated and widely used OSATS) and the change in the percentage of OB attendings who achieve competency (score of 60) from baseline to program completion.
Our main hypotheses are that the PPH technical skills simulation program will show a significant increase in skill level among OB attendings and that the proposed innovations (affordable, remote, asynchronous) will address known barriers to implementation. We propose the following specific aims:
Aim 1: Establish simulation as an effective means for training OB attendings in technical skills for treating PPH by validating a high-fidelity simulator and rigorously evaluating its effectiveness for a PPH technical skills simulation program with an in-person mentoring program.
Aim 2: Evaluate three innovations aimed at overcoming common barriers to simulation training for OB attendings:
- Aim 2A: Validate a novel, affordable medium-fidelity simulator and evaluate its effectiveness in a PPH technical skills program using in-person mentoring.
- Aim 2B: Evaluate a PPH technical skills simulation program with remote synchronous mentoring.
- Aim 2C: Evaluate a PPH technical skills simulation program with asynchronous mentoring.
Aim 3: Evaluate the effectiveness of a PPH technical skills simulation program in rural and community hospital settings, using an approach that sufficiently addresses the barriers to implementation established in Aim 2 (affordable, remote, asynchronous) and is acceptable to OB attendings.
If successful, the results will inform best practices in obstetrics, advance the integration of simulation in medical education and training standards, and enable dissemination in varied settings nationwide.
Postpartum hemorrhage (PPH) is a rare but potentially catastrophic obstetric emergency and a leading cause of severe maternal morbidity and preventable mortality in the U.S. Women of racial and ethnic minority groups and those living in underserved and remote areas are at the greatest risk. Obstetric units must be prepared to manage PPH, and obstetric (OB) attendings must maintain the technical skills necessary to control PPH. To address this, simulation is a promising approach.
Obstetric simulation has shown effectiveness for team-based training, yet there is compelling evidence for the use of simulation to improve technical skills. Furthermore, prior studies and simulation research from other surgical specialties demonstrate the high likelihood of successfully validating an existing high-fidelity simulator and establishing its effectiveness in training OB attendings in the technical skills needed to manage PPH. However, a simulation program directed at OB attendings who work in varied hospital settings across the country is subject to known obstacles for implementing and spreading simulation.
We propose a staged, multicenter study to establish simulation, using innovative approaches to mitigate barriers, as an effective means for training OB attendings in three technical skills demonstrated as effective for controlling PPH: Bakri balloon placement, B-Lynch suture placement, and O'Leary suture placement. OB attendings will be assessed at baseline, mentored, and re-assessed. The primary outcomes will be the change in assessment scores (measured by validated and widely used OSATS) and the change in the percentage of OB attendings who achieve competency (score of 60) from baseline to program completion.
Our main hypotheses are that the PPH technical skills simulation program will show a significant increase in skill level among OB attendings and that the proposed innovations (affordable, remote, asynchronous) will address known barriers to implementation. We propose the following specific aims:
Aim 1: Establish simulation as an effective means for training OB attendings in technical skills for treating PPH by validating a high-fidelity simulator and rigorously evaluating its effectiveness for a PPH technical skills simulation program with an in-person mentoring program.
Aim 2: Evaluate three innovations aimed at overcoming common barriers to simulation training for OB attendings:
- Aim 2A: Validate a novel, affordable medium-fidelity simulator and evaluate its effectiveness in a PPH technical skills program using in-person mentoring.
- Aim 2B: Evaluate a PPH technical skills simulation program with remote synchronous mentoring.
- Aim 2C: Evaluate a PPH technical skills simulation program with asynchronous mentoring.
Aim 3: Evaluate the effectiveness of a PPH technical skills simulation program in rural and community hospital settings, using an approach that sufficiently addresses the barriers to implementation established in Aim 2 (affordable, remote, asynchronous) and is acceptable to OB attendings.
If successful, the results will inform best practices in obstetrics, advance the integration of simulation in medical education and training standards, and enable dissemination in varied settings nationwide.
Funding Goals
NOT APPLICABLE
Grant Program (CFDA)
Awarding / Funding Agency
Place of Performance
New York,
New York
100323720
United States
Geographic Scope
Single Zip Code
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 191% from $704,597 to $2,050,199.
The Trustees Of Columbia University In The City Of New York was awarded
Project Grant R01HD107451
worth $2,050,199
from the National Institute of Child Health and Human Development in June 2022 with work to be completed primarily in New York New York United States.
The grant
has a duration of 5 years and
was awarded through assistance program 93.865 Child Health and Human Development Extramural Research.
The Project Grant was awarded through grant opportunity Medical Simulators for Practicing Patient Care Providers Skill Acquisition, Outcomes Assessment and Technology Development (R01 Clinical Trial Not Allowed).
Status
(Ongoing)
Last Modified 6/20/24
Period of Performance
6/21/22
Start Date
5/31/27
End Date
Funding Split
$2.1M
Federal Obligation
$0.0
Non-Federal Obligation
$2.1M
Total Obligated
Activity Timeline
Subgrant Awards
Disclosed subgrants for R01HD107451
Transaction History
Modifications to R01HD107451
Additional Detail
Award ID FAIN
R01HD107451
SAI Number
R01HD107451-2289445850
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Private Institution Of Higher Education
Awarding Office
75NT00 NIH EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
Funding Office
75NT00 NIH EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
Awardee UEI
QHF5ZZ114M72
Awardee CAGE
3FHD3
Performance District
NY-13
Senators
Kirsten Gillibrand
Charles Schumer
Charles Schumer
Budget Funding
Federal Account | Budget Subfunction | Object Class | Total | Percentage |
---|---|---|---|---|
National Institute of Child Health and Human Development, National Institutes of Health, Health and Human Services (075-0844) | Health research and training | Grants, subsidies, and contributions (41.0) | $1,387,144 | 100% |
Modified: 6/20/24