Continuing Medical Education

Effectiveness evaluation of the simulated vaginal operative delivery training program based on Kirkpatrick's model and diffusion of innovations theory

  • Sun Xiao ,
  • Zhang Mengying ,
  • Sun Yu
Expand
  • Obstetrics and Gynecology Reproductive Medicine Center, Peking University First Hospital, Beijing 100034, China

Received date: 2025-08-12

  Online published: 2026-07-01

Supported by

The Teaching Project Funding of Peking University First Hospital in 2023(2023YJ17)

Abstract

Objective To conduct a multidimensional effectiveness evaluation of the simulated vaginal operative delivery training program conducted in the Department of Obstetrics and Gynecology, Peking University First Hospital, based on Kirkpatrick's four-level evaluation model and the Diffusion of Innovations Theory, and to provide evidence for optimizing obstetric operative training. Methods A questionnaire survey method was employed. A total of 96 participants from 5 training sessions conducted from May 2022 to May 2024 were included in the study. Data were collected through questionnaires and one-year post-training follow-ups to evaluate training effectiveness from the three dimensions (reaction, learning, and behavior) of Kirkpatrick's four-level evaluation model. The Diffusion of Innovations Theory was introduced to describe the collective impact triggered by the training. Data were described using mean scores, numbers, and percentages. Results Reaction level: The average satisfaction scores ranged from 19.3 to 19.7 (out of 20), all indicating ″very satisfied″. Learning level: The intended clinical application rates for the four courses, from highest to lowest, were forceps delivery simulation [89/96 (92.7%)], vacuum extraction simulation [80/96 (83.3%)], forceps technique [74/96 (77.1%)], and vacuum extraction technique [59/96 (61.5%)]. Behavior level: One year post-training, 41 participants were followed up; 29 (70.7%) had applied the learned techniques. Forceps delivery was most applied [23 (79.3%)], followed by vacuum extraction [6 (20.7%)]. Of these, 28 (96.5%) performed their first procedure within 0-3 months post-training. Furthermore, 32 (78.0%) reported significant improvement in procedural standardization. Regarding collective impact, the training program demonstrated positive diffusion effects on clinical practices across 10 participating hospitals, showing potential for regional practice improvement. Conclusions The training program achieved high satisfaction and significant knowledge/skill improvement, with high and timely behavioral transfer, especially for forceps delivery. Using the Diffusion of Innovations Theory as a complementary framework effectively describes the diffusion of trained behaviors from individual mastery to group practice, laying a foundation for future evaluation of long-term organizational benefits.

Cite this article

Sun Xiao , Zhang Mengying , Sun Yu . Effectiveness evaluation of the simulated vaginal operative delivery training program based on Kirkpatrick's model and diffusion of innovations theory[J]. Chinese Journal of Medical Education, 2026 , 46(7) : 544 -548 . DOI: 10.3760/cma.j.cn115259-20250812-00942

References

[1] 周玉博, 李宏田, 朱丽萍, 等. 1993至2010年中国部分地区阴道助产分娩率变化趋势[J].中华医学杂志,2014,94(45):3599-3602. DOI: 10.3760/cma.j.issn.0376-2491.2014.45.017.
[2]苏畅, 周梦林, 陈丹青. 浙江省154家医院及其助产人员难产助产技术开展和掌握情况研究[J].中华医学教育杂志,2022,42(7):665-669. DOI: 10.3760/cma.j.cn115259-20211025-01311.
[3]钟逸锋, 宋英娜, 汤萍萍, 等. 导师现场传授与录像演示在产钳助产模拟教学中的效果评估[J].中华全科医师杂志,2023,22(1):69-73. DOI: 10.3760/cma.j.cn114798-20220711-00752.
[4]王挺,江若安,徐冬,等. 产钳助产模型在妇产科住院医师规范化培训中的应用探索及思考[J]. 中国高等医学教育,2024(7):86-87,90. DOI:10.3969/j.issn.1002-1701.2024.07.029.
[5]郭晓玥, 王妍, 王伽略. 混合式教学模式在产钳助产手术模拟教学中的应用效果[J].中华医学教育杂志,2022,42(9):811-814. DOI: 10.3760/cma.j.cn115259-20220217-00177.
[6]马向南,刘清.国内外培训效果评估方法综述[J].继续教育研究,2020(5): 57-60. DOI: 10.3969/j.issn.1009-4156.2020.05.014.
[7]孙丹丹, 梁涛. 柯氏评估模型在医学相关培训中的应用现状[J]. 中华护理教育, 2015, 12(12): 947-949. DOI:10.3761/j.issn.1672-9234.2015.12.017.
[8]Rogers EM.Diffusion of innovations[M].New York:The Free Press,1983:1-15.
[9] McGaghie WC, Issenberg SB, Cohen ER, et al. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? a meta-analytic comparative review of the evidence[J]. Acad Med, 2011,86(6):706-711. DOI: 10.1097/ACM.0b013e318217e119.
[10]Arthur W , Bennett W , Stanush PL ,et al. Factors that influence skill decay and retention: a quantitative review and analysis[J].Human Performance, 1998, 11(1):57-101. DOI:10.1207/s15327043hup1101_3.
[11] Doulaveris G, George KE, Gressel GM, et al. Resident and program director confidence in resident preparedness for operative vaginal deliveries in Obstetrics and Gynecology Training Programs in the United States[J]. Am J Obstet Gynecol MFM, 2022,4(1):100505. DOI: 10.1016/j.ajogmf.2021.100505.
[12]Hamza A, Lavin JP, Radosa JC, et al. Vaginal operative delivery in Germany: a national survey about experience and self-reported competency[J]. J Matern Fetal Neonatal Med, 2022,35(7):1363-1369. DOI: 10.1080/14767058.2020.1755648.
[13] McGaghie WC, Issenberg SB, Barsuk JH, et al. A critical review of simulation-based mastery learning with translational outcomes[J]. Med Educ, 2014,48(4):375-385. DOI: 10.1111/medu.12391.
Outlines

/