By Dr Ong Zhong Wei, MRCOG
Trainer, ICOE, OGSM

(Published in AOFOG Newsletter January 2023, Volume 1/2023 & OGSM CONNECT Newsletter April 2023, Issue 2, Council 2022/2023)

The ICOE team from OGSM had our first opportunity to introduce our curriculum to Laos counterpart since March 2020. A group of passionate young obstetricians and gynaecologist were then trained as participants and volunteered themselves as pioneer trainers. The mission shared by both Malaysian and Laotian trainers is Laos would eventually run ICOE suited to their local settings, with initial supervision from Malaysian trainers, guided by The Handbook in Obstetric Emergencies, the course’s key resource and the ICOE Trainer Manual.

The strategic roll out plans for Laos was forced on hold due to unexpected COVID-19 pandemic. After a hiatus of 3 years, with great support from AOFOG and OGSM, a team of 5 Malaysian trainers, armed with COVID-19 vaccinations and fueled with vehemence to reignite ICOE in Laos, travelled to Vientiane, Laos on 12 to 15 Jan 2023. Incidentally there are no direct flights to Vientiane, which pushes us to our wits’ end to travel with 120kg equipment

Arrival at Vientiane, 12th Jan 2023
Return to KLIA 2, 15th Jan 2023

After a brief transit in Don Mueang Airport, Bangkok. We arrived on Vientiane Airport on 12 January 2023. We were warmly welcomed by the local trainers. First destination was to Hospital and set up pre skill test stations. Local trainers underwent a refresher regarding the run down for 2 days course, and guidance given on how to set up each breakout stations. A conducive lecture hall well equipped with audio visual system provided by committee were one of the keys to our course’s success.

Lecture hall in Vientiane Mother and Child Hospital
Welcome speech by Professor Pisake Lumbiganon, AOFOG President

Initial challenge faced was language barrier, where majority of local participants are not well versed in English communication. This was promptly rectified by translating our messages into Laos language by the local trainers. Local trainers are able to retain, retrieve and reproduce all teaching points given by Malaysian trainers effectively. We had ample opportunity to exchange ideas with local trainers, and gained much more from their experience.

The one who teaches, learns the most

Overall, participants and local trainers were overwhelmingly satisfied with our course. It was a delightful honour to know that materials from The Handbook of Obstetric Emergencies are currently incorporated into Laos post graduate O&G training. Some participants commented that this ICOE is an eye-opening experience to them, as they have not been exposed to simulation training in healthcare. In fact, this is the first experience for most of the participants to practice CPR and defibrillator on mannequins. Apart from experiencing some of the new advancement in simulation training, they have also learnt some cost effective but potentially life-saving methods such as ; IV Tranexamic Acid, Aortic Compression and Bimanual Compression.

Training Outcomes
A total of 24 postgraduate doctors from the various provinces participated in the course. They were provided with a E-Handbook and videos 2 weeks before the course. This allows self-paced adult learning online. They were then tested with an online knowledge test which they completed before the course.

Looking forward, O&G Society of Laos are working hand in hand with their Ministry of Health, with allocations provided to set up a local simulation healthcare training center in 2025. They are planning to kick start their own version of “mini-ICOE” in May and August this year, with the objective to roll out awareness and exposure to other regions beside Vientiane. The Laos committee had also graciously invited us for another ICOE in October this year. We are truly impressed by their ministry’s political will and society’s commitment towards improving safe pregnancy and safe childbirth. The success of the training for the past few years lies in the committed leadership provided by the industrious Professor Dr Alongkone to which ICOE is indebted.

Sitting (from Left): 1) Dr Gunasegaran Rajan, ICOE principal trainer, 2) Dr Angela Chin Yeung Sing, ICOE course coordinator, 3) Dr Alongkone Phengsavanh, Vice Dean, University of Health Sciences

Soft uterus model to practice compression sutures. Attaching soft uterus model to PROMPT model for better fidelity. Innovative effort by Mr Baskeran, ICOE Executive

Shoulder dystocia hands on
Assisted breech delivery hands on
Forcep delivery hands on
Genital tract trauma repair hands on