OB/GYNs face fewer malpractice claims after attending training simulation

The rate of malpractice claims before and after a training simulation was reduced significantly among OB/GYN physicians, suggesting the need for better communication in the workplace, according to a study in Obstetrics and Gynecology.

“The goals of team training using simulation include enhancing participants’ ability to communicate effectively and elicit the opinions of other members of the team in high-stakes situations,” Adam C. Schaffer, MD, MPH, an instructor of internal medicine at Harvard Medical School and an attending physician at Brigham and Women’s Hospital, and colleagues wrote.

Most malpractice claims stem from miscommunication or a team’s “dysfunctional hierarchy,” according to the study. Researchers used a retrospective analysis to assess the association between malpractice claims and training sessions among OB/GYN physicians in the Boston area.

The study included 292 participants who all trained at the Center for Medical Simulation; 55.5% of participants attended only one session and 19.9% attended three or more sessions. All participants were insured by the malpractice insurer included in the study.

Researchers assessed claim rates during the full study period, which lasted from 2002 to 2019; during a 2-year study period before and after the training session; and during a 1-year study period before and after the training session. The difference in claim rates in the 1-year study period was not statistically significant, they found.

For the full study period, however, malpractice claim rates declined significantly. Before training, there were 11.2 claims per 100 physician coverage years (95% CI, 9.4-13.2), which the study defined as “1 year of coverage of one physician by the malpractice insurer.” After training, there were 5.7 claims per 100 physician coverage years (95% CI, 4.7-6.8).

Schaffer and colleagues found that rates also decreased during the 2-year period. There were 9.2 claims per 100 physician coverage years (95% CI, 6.4-12.6) before training, which declined to 5.4 claims per 100 physician coverage years (95% CI, 3.6-7.7).

Physicians who attended more than one session had even lower claim rates than their peers. Researchers concluded that the training improved groupwork and patient care.

The study’s limitations included the inability to determine a causal relationship between the simulation and malpractice claim rates. Also, all the participants were from the Boston area, so the data are not representative of other populations.

“Given the ongoing need for improvement in patient safety within obstetrics and gynecology, and the large size of the indemnity awards the risk of which could potentially be reduced after simulation training, the more widespread use of simulation training within obstetrics and gynecology should be considered,” Schaffer and colleagues wrote.