Simulation-Based Training for Postpartum Hemorrhage Management: Predictors of Competency Gain and Implications for Patient Safety

Postpartum hemorrhage (PPH) is a high-stakes obstetric emergency in which delayed recognition and inadequate structured management may result in severe maternal morbidity. Medical students have limited exposure to such scenarios during clinical rotations, raising concerns regarding preparedness for emergency obstetric care. Simulation-based training has been proposed to address this situation; however, its impact on emergency-specific performance, confidence calibration, and determinants of skill acquisition remains incompletely understood. Methods: A single-group prospective pre–post-educational intervention study was conducted among sixth-year medical students following an obstetrics and gynecology rotation. Participants completed a structured high-fidelity simulation module focused on PPH management. Outcomes included an objective composite performance score and self-assessed emergency confidence. Results: A total of 215 students were included. Simulation-based training resulted in substantial improvements in PPH composite performance (scaled 0–1: 0.34 ± 0.20 to 0.67 ± 0.23; p < 0.001; Cohen’s dz = 1.38). Conclusions: Structured simulation-based PPH training markedly enhances emergency management performance among final-year medical students. Learning gains are primarily determined by baseline competence, while motivational responses are influenced by perceived realism, supporting the integration of structured emergency simulation into undergraduate curricula.