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Team Members:
  • Kendall Covington
  • Sakina Girnary
  • Teja Maruvada
  • Ramji Rengarajan
  • Kavya Singampalli
  • Soumyadipta Acharya, MD, PhD
  • Rashmi Asif, MBBS
  • Cherrie Evans, CNM
  • Tor Inge Garvik, MS
  • Jennifer Gilbertson, MSE
  • Lindsay Litwin, MPH
  • Pushkar Ingale, MDes
  • Swati Mahajan, MBBS, MPH
  • Harshad Sanghvi, MD
  • Pallavi Sinha, MBBS
  • Rachel Willardson, MS


Each year, 350,000 women and 2 million babies die from birth-related complications. In India specifically, the UN Millennium Development Goals 4 and 5 aim to reduce high infant mortality rates, decrease the maternal mortality ratio, and increase birth attendance by skilled health professionals. To achieve this, nursing schools that are currently training students using a standardized curriculum have recently added Skills Labs to expose students to skill-based and simulation-based training practice, apart from a clinical internship during the final year of nursing education. However, many of the labour monitoring skills taught in the curriculum are not translated to the clinical site due to the lack of interactive, immersive and integrated training. This leads to a lack of nurse empowerment to make important decisions in emergent situations that can save both the mother and child.

We have developed a training system to improve the current labour monitoring training system by integrating the measurement, recording, interpreting and acting aspects, habituating nursing students to make more timely measurements and decisions, and encouraging a low-dose high-frequency training approach without the need for direct faculty involvement. Our device, Physim, allows students to practice and learn measurements, plot data onto a partograph, and make decisions throughout the progress of labour. It incorporates a physical model containing modules for fetal heart rate, contractions, and cervical dilatation, which connects to a flipbook user interface where the user plots data on a partograph. After each measurement is complete, the student assesses the parameters to ensure that labour is progressing normally and appropriate actions are taken.

PhySim offers significant advantages over the traditional case study approaches by encouraging dialogue and discussion among the students and enhancing the learning for both the user and the operator. PhySim also incorporates group-based simulation, that has been shown extensively to improve learning comprehension and retention.This system habituates the student to take measurements in a timely manner, make decisions at each time point after measurements are taken, and contextualize those measurements in the progression of labour. By providing exposure to both the normal and abnormal progression of labour in the training setting using a low dose high frequency training routine, students will be able to build their confidence before reaching the clinical site, and will be better-equipped to make evidence-based decisions in practice.

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