This 5-minute video was produced to serve as an introductory lecture before having students practice on manikins and other common objects.

The Behind the Scenes version provides a commentary by Dr. Hughey on some of the issues he faced during the production of the video.

Discussed in this commentary are the use of graphics versus real-life video of exams in progress.

Video

The Behind the Scenes video may be accessed here.

Transcript

Welcome to the behind the scenes commentary.

I’m Dr. Hughey and I’d like to share with you some of the technical issues I encountered during production of this video.

I wanted to cover the basics in about 5 minutes. Longer and students would lose interest. Shorter and I wouldn’t have time to get everything important in.

After a brief establishing shot, I switched to a graphic to demonstrate progressive dilatation, effacement and descent. I used Microsoft photodraw to create the graphic, but any graphic program would have worked.

Cervical evaluation is hard to learn, because it is done totally by feel, and based on experience. I wanted to present some common objects on which the students could practice.

Graphics are the best way of presenting the concept of effacement. But I still wanted to tie the concept back into the water bottle metaphore.

For station, I used both a model for the overview, and a graphic to give specifics.

For the graphic, I started with a picture of a bony pelvis that showed the spines, as they are the key landmarks. Then I made several layers. The first layer was the pelvis. The second layer was a pink oval for the fetal head. The third layer was a cut out copy of the front of the pelvis that I placed precisely over the fetal head. For clarity, I made it little transparent so the viewer could still make out the shape of the fetal head behind it.

Then, I adjusted the fetal head up and down to represent several different stations.

Graphical representation of labor is a useful teaching tool, whether one is a supporter of the Friedman curve or not.

I started my discussion of fetal position with filmed examples, to establish an overview of the concept and to mix in some real life with the models.

Years ago, I acquired this obstetrical pelvis and baby. It is very useful for teaching because it is just realistic enough to show important landmarks, but all open so the students can see what is actually going on.

The model is placed on navy blue fleece blanket so the background is completely obscured, forcing the viewers eyes to look only at the model.

I added the flashing obstetric emergency sign and the sound of the siren to convey the urgency of the situation on an emotional level. I hoped the graphic pictures would be remembered by the students, should this emergency arise.

To portray fetal suture lines and fontanelles, I used a black marker on the doll.

While palpating suture lines and the breech, I used my gloved fingers as though I were performing an exam in labor, to convey the motions one would use.

I wanted to include a video clip of amniotic fluid escaping from the vagina. While this is a familiar site to experienced L&D personnel, it needs to be demonstrated to the novice.

Nitrazine paper is used less now than in the past, but I wanted to demonstrate a strongly positive response.

For evaluation of the pelvis, I went back to my pelvic model. The most difficult part of capturing this video was getting the camera angle just right to show what I’m feeling.

While I liked the video clips, I still felt I needed a still picture on which I could put labels, to make it very clear what I was talking about.

I close the video with a live example of a digital exam in progress, to bring the theory back to reality.