Training the trainers: teaching caesarean surgical skills virtually in the South Asian region

Throughout 2022, the Obstetric & Gynaecological Society of Malaysia (OGSM) and the South Asian Federation of Obstetrics and Gynaecology (SAFOG) collaborated on the delivery of virtual training sessions to improve the skills of surgeons performing caesarean section.

virtual c-section training

Doctors from Bangladesh, India, Nepal, Pakistan and Sri Lanka joined the virtual training under the leadership of Dr Rohana Hathatouwa, SAFOG President.

The training aimed to teach caesarean section skills, recognising that c-section rates in the region are on the rise and that, most often, the surgeries are performed by junior doctors who are in need of further training. In particular, the course focused on “training the trainer”, with 30 doctors from the five participating countries taking part, including five course “champions” who will, in the future, share these surgical skills with others.

Delivering the training course

Following the enrolment of the participants in early 2022, the Handbook of Obstetric Emergencies was made available to them as an online resource. The “Intensive Course in Obstetric Emergencies (ICOE) – SAFOG Caesarean Course” online platform hosted the necessary training resources, including pre-recorded video lectures.

The training course covered surgical skills, documentation, the World Health Organization safe surgery check list, consent and risk management. The videos focused on themes such as delivering abnormal foetal presentation, failed second stage, foetal pillow, instrumental delivery, tears and bleeders, B- Lynch Suturing, systematic pelvic devascularisation, and placenta spectrum disorders management. Participants completed the modules between June and July 2022, at which point their skills were assessed – with a score of 70% required to complete the course.

Demonstrating key skills in caesarean delivery

In August 2022, senior trainers from OGSM conducted a virtual skills demonstration session. 30 participants gathered in a single centre to demonstrate their competencies through supervised simulations using low- to medium-fidelity equipment.

Participants had to demonstrate their abilities in a selection of key skills: handling tears and bleeds, foetal malpresentations, failed second stage, B lynch suturing, placenta previa and systematic pelvic devascularisation. All participants successfully completed the assessment and became probationary trainers.

trainers in workshop

Passing on caesarean surgical skills: beyond the training course

In late September 2022, four trainers from OGSM and six probationary trainers from Sri Lanka delivered a pre-Congress caesarean skills hands-on workshop at the SAFOG Silver Jubilee Congress in Colombo, Sri Lanka. The workshop was organised at the Lankan Hospital and attended by 28 participants and six observers.

It was my privilege to have attended this resourceful training session. It brought us new information which will help in our clinical management. The programme was well conducted to reach our minds. The contents of the session were well selected to adapt to the current medical problems.

– Dr Vasanthi Vamadevan Jeyaviran, Lankan Hospital, Colombo

The virtually trained surgeons now have the ability to share their skills with others in the South Asia region. The next instalment of the training programme is being organised between OGSM and SAFOG for 2023–2024, to enable those trained in 2022 to teach c-section surgical skills to others.



Dr Rohana Hathotuwa, President, SAFOG


Dr Thaneemalai Jeganathan (ICOE-SAFOG) Programme coordinator

Datuk Zaridah Safie, Dr Yong Soon Leong & Mr Baskaran Balakrishan (ICOE Executive)

National societies champions

Dr. U. D. P. Rathanasiri, Sri Lanka College of Obstetricians and Gynaecologists

Prof Rubina Sohail, Society of Obstetricians & Gynaecologists of Pakistan

Prof Farhana Dewan, Obstetrical and Gynaecological Society of Bangladesh

Prof Ganesh Dangal, Nepal Society of Obstetricians and Gynaecologists

Dr Shyam Desai, Federation of Obstetric and Gynecological Societies of India