Evidence map›Paper›PMID 41537048›Full record

ArticleAJOG global reports2026

Development and evaluation of an external cephalic version simulation-based educational program.

Dhanalakshmi Thiyagarajan, Megan Gauger, Raj Patel, Thelma Quarshie, Enaam A Adanu, Julia Kramer, Kathleen H Sienko, Cheryl A Moyer, Molly Stout, Deborah M Rooney and 3 more

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Article in AJOG global reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Dhanalakshmi ThiyagarajanDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
Megan GaugerUniversity of Michigan Medical School, University of Michigan, Ann Arbor, MI.
Raj PatelDepartment of Learning Health Sciences, University of Michigan, Ann Arbor, MI.
Thelma QuarshieDepartment of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana.
Enaam A AdanuDepartment of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana.
Julia KramerDepartment of Mechanical Engineering, University of Michigan, Ann Arbor, MI.
Kathleen H SienkoDepartment of Mechanical Engineering, University of Michigan, Ann Arbor, MI.
Cheryl A MoyerDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
Molly StoutDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
Deborah M RooneyDepartment of Learning Health Sciences, University of Michigan, Ann Arbor, MI.
Samuel A OppongDepartment of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana.
Alim Swarray-DeenDepartment of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana.
Emma LawrenceDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFetal malpresentation contributes significantly to cesarean deliveries. External cephalic version (ECV) reduces this risk but requires skilled performance. In low-resource settings, limited training opportunities hinder its use, highlighting the need for effective simulation-based education.

objectiveThis study aimed to develop and evaluate an external cephalic version simulation-based educational program. STUDY

designWe used Kern's 6-step framework to develop a program composed of 6 learning objectives with 6 distinct components specifically for low-resource settings. We conducted a 3-round modified Delphi panel to modify the program. We evaluated the program through a cluster randomized study of obstetrics and gynecology house officers, junior residents, senior residents/fellows, and consultants/attendings in January 2025 at Korle Bu Teaching Hospital in Ghana. Self-reported comfort and confidence, knowledge, skill, and program feasibility and acceptability were analyzed using

resultsThe Delphi panel consisted of 14 experts from 5 countries. At least 80% consensus on all external cephalic version program components was reached before implementation. The learning group's self-reported comfort and confidence (

conclusionOur external cephalic version simulation-based program improves comfort and confidence, knowledge, and skill among Ghanaian clinicians. Given that external cephalic version success depends on the skill of the performing clinician, our program may help increase external cephalic version rates and thus decrease the rates of avoidable cesarean delivery and its complications.

Indexed as

malpresentationobstetrics educationpreventing cesarean deliveriessimulation

Identifiers

PMID41537048
PMCPMC12797051

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.