SIMULATION OF CERVICAL CHANGES IN LABOUR: REPRODUCIBILITY OF EXPERT ASSESSMENT

A carefully designed set of simulators showing cervical effacement and dilatation was used to assess the error within and between observers in a group of 36 midwives and 24 obstetricians. No observer was correct in every case. There was no significant difference between the obstetricians and the midwives in assessment of effacement or overall assessment of dilatation. However, midwives were significantly more likely than obstetricians to assess dilatation inaccurately by more than 1 cm. Inaccuracy was greatest in the simulators 5-7 cm dilated. These findings have implications for labour management and teaching.