Project Title: Cognitive Task Analysis for Vaginal Examinations of Pregnant Women

Current Funder: Imperial College Healthcare Charity

Project Summary

Vaginal examination is a routine examination that is conducted to determine the progression of labour. Trainee obstetricians and midwives currently practice vaginal examinations in real clinical scenarios, which can increase the number of examinations and level of patient discomfort. Moreover, it can create significant anxiety in the trainee who may well be nervous and unsure of the procedure. Improving training can lead to increased reliability in determining the progression of labour and provide clinicians with greater confidence in their skills. 

Simulation can optimise limited resources, address ethical concerns, reduce anxiety and alleviate patient safety issues by offering the opportunity to learn and develop skills in a safe environment without causing distress to patients. Virtual reality simulators enable visualisation in addition to haptic (touch) feedback of normally unsighted examinations, improving the understanding between the trainer and student of what is being felt during the examination. It can be hypothesised that improving training can lead to increased reliability in determining the progression of labour and provide clinicians with greater confidence in their skills. This enables clinicians to perform fewer examinations overall and reduce the distress experienced by patients.

The goal of this project is to systematically capture expert knowledge of performing a vaginal examination of a pregnant woman using a method known as cognitive task analysis (CTA), which breaks down the process into its fundamental steps, including elements performed unconsciously. Defining the sequence of steps required to successfully perform the examination can be used to both improve teaching and assessment, as well as inform the development of a range of simulators.

Project Aim:

 The specific objectives of this project are as follows:

• To develop a sensor embedded benchtop model which can record and collect fingertip’s movement and force.
• To collect dataset with consultant obstetricians and midwives based on the benchtop model.
• To analyse essential skills for the vaginal examination by breaking down the sequence of steps
• To develop teaching materials and assessment criteria for medical education of the vaginal examination.
• To come up with the requirements for a training simulator of the vaginal examination.