Accurate assessment of cervical dilation and effacement is essential to effective labor management. Current approaches to training medical students in this skill often rely upon limited bedside examination of real patients, or less often, upon simulation models which are expensive and do not effectively demonstrate progressive dilation and effacement.
This lab was developed by Rachel Hansen, a fourth year medical student at the University of South Carolina School of Medicine, in response to her and other students’ concerns with the lack of objectivity in cervical assessment training during a third year OBGYN clerkship. Upon reviewing course curriculums and conferring with students and instructors from other schools, a consistent lack of teaching in this area was observed across the board. This hands-on lab was designed to address this need, incotporating simple, inexpensive clay models to improve student visual and tactile appreciation of cervical dilation and effacement and improve accuracy in assessment. This exercise is also helpful in meeting APGO Educational Objectives for intrapartum care (Unit 2; Topic 11: Intrapartum Care; Item 2).
This online toolkit provides a twelve minute didactic student lecture covering pertinent pelvic anatomy, stages of labor, steps in cervical assessment, as well as techniques, risks, benefits, and indications for cervical assessment. Also available is a ten minute instructors’ guide with a review of the current literature on this topic, step-by-step instructions for forming the clay models, and suggestions for implementing the lab. The same material is covered in written form in the accompanying lab manual. Finally, the toolkit provides a model worksheet for teaching dilation and effacement, a skills assessment worksheet for testing purposes, and a checklist for use in an OSCE evaluation.