C36-07 Improving Critical Care Competency in Obstetric Emergencies Through Simulation-based Training

Abstract Rationale Severe maternal morbidity in the United States has increased nearly 200% over recent decades, with a maternal mortality rate of 17.4 per 100,000 deliveries. Despite this, obstetric patients account for only 2.1% of mechanically ventilated ICU cases, leaving many critical care trainees underexposed to these complex scenarios. Simulation-based education offers an opportunity to address this educational gap by providing structured, high-fidelity experiences in a controlled environment. We developed and evaluated a simulation-based curriculum to enhance pulmonary and critical care medicine (PCCM) fellows’ knowledge and confidence in managing respiratory failure and cardiac arrest in obstetric patients. Methods A high-fidelity simulation was designed using a “pregnant” mannequin (SimMom, Laerdal), integrated with real-time vital signs and a mechanical ventilation simulator (ASL5000, Ingar Medical) capable of reproducing respiratory failure with changing respiratory physiology. Participants completed a baseline confidence assessment across key management domains using a 5-point Likert scale (Figure 1) and a 10-item multiple choice baseline knowledge assessment. Next, participants completed a two-part simulation: (1) acute respiratory failure leading to mechanical ventilation, and (2) clinical decompensation and cardiac arrest. Performance was evaluated with a 36-item learning objective checklist. Structured debriefing and targeted didactic teachings were provided at the scenario mid-point and completion. A 10-item post-test and confidence assessment were then administered, and pre- and post-intervention data were compared using paired t-tests. Results Of 16 PCCM fellows, 4 have completed the curriculum to date. The mean pre-test score was 6.3 ± 0.96 compared to 7.5 ± 1.29 post-intervention (p = 0.19). The mean performance score on the learning objectives checklist was 24 ± 5.16. Learners demonstrated significant gains in self-reported confidence across several domains (Figure 1). Conclusions A targeted simulation-based curriculum improved PCCM fellows’ confidence in managing critical obstetric emergencies. Preliminary data demonstrates a non-significant increase in knowledge while a learning objectives checklist demonstrates several gaps in current trainee management. Simulation may provide an effective, reproducible framework to strengthen trainee preparedness for high-acuity, low-frequency events in obstetric critical care. Ongoing work aims to assess skill retention and broaden the curriculum to encompass additional obstetric emergencies, including eclampsia and acute liver failure. This abstract is funded by: None