Uterine bleeding, particularly postpartum hemorrhage, remains one of the leading causes of maternal morbidity and mortality worldwide. Rapid recognition and effective management of obstetric bleeding are essential competencies for future healthcare professionals. However, traditional medical education often provides limited opportunities for students to practice emergency obstetric interventions due to concerns about patient safety. Simulation-based education has emerged as an effective approach for teaching complex clinical skills in a safe and controlled environment. The aim of this study was to evaluate the effectiveness of simulation-based training in improving medical students' competence in the management of uterine bleeding. A prospective educational study was conducted at the simulation training center of Tashkent State Medical University during the 2025–2026 academic year. A total of 100 senior medical students participated in the study and were divided into two groups: a simulation training group (n=50) and a control group (n=50) receiving traditional clinical instruction. The simulation program included structured obstetric emergency scenarios focusing on uterine bleeding management, postpartum hemorrhage control, patient assessment, and teamwork in emergency care. Students' competencies were assessed using Objective Structured Clinical Examination, instructor evaluation checklists, and pre- and post-training knowledge tests. Statistical analysis was performed using descriptive statistics and Student's t-test, with statistical significance set at p < 0.05. Students who participated in simulation-based training demonstrated significantly higher clinical competence scores compared with the control group. The mean Objective Structured Clinical Examination score increased from 56.8 ± 7.4 before training to 86.2 ± 6.1 after simulation training (p < 0.001), while the control group showed only moderate improvement (57.1 ± 7.2 to 69.4 ± 6.9). Simulation-trained students also demonstrated better performance in recognizing uterine bleeding, initiating emergency management, and coordinating team-based care. Simulation-based training significantly improves medical students' competence in managing obstetric emergencies such as uterine bleeding. Integration of structured simulation programs into medical curricula may enhance clinical preparedness and contribute to improving maternal healthcare outcomes.

Simulation-based learning, obstetric simulation, uterine bleeding

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun;2(6):e323-33. https://doi.org/10.1016/s2214-109x(14)70227-x

World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: World Health Organization; 2012.

World Health Organization. Global health agencies issue new recommendations to help end deaths from postpartum haemorrhage [Internet]. Geneva: World Health Organization; 2025 Oct 5 [cited 2026 Mar 12]. Available from: https://www.who.int/news/item/05-10-2025-global-health-agencies-issue-new-recommendations-to-help-end-deaths-from-postpartum-haemorrhage

World Health Organization. A roadmap to combat postpartum haemorrhage between 2023 and 2030. Geneva: World Health Organization; 2023.

Williams CR, Adnet G, Gallos ID, Coomarasamy A, Gülmezoglu AM, Islam MA, Rushwan S, Widmer M, Althabe F, Oladapo OT. Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise. BMJ Glob Health. 2024 Nov 7;9(11):e015342. https://doi.org/10.1136/bmjgh-2024-015342

Maswime S, Buchmann E. A systematic review of maternal near miss and mortality due to postpartum hemorrhage. Int J Gynaecol Obstet. 2017 Apr;137(1):1-7. https://doi.org/10.1002/ijgo.12096

Rath WH. Postpartum hemorrhage--update on problems of definitions and diagnosis. Acta Obstet Gynecol Scand. 2011 May;90(5):421-8. https://doi.org/10.1111/j.1600-0412.2011.01107.x

Main EK, Goffman D, Scavone BM, Low LK, Bingham D, Fontaine PL, Gorlin JB, Lagrew DC, Levy BS. National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage. Anesth Analg. 2015 Jul;121(1):142-148. https://doi.org/10.1097/aog.0000000000000869

Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017 Oct;130(4):e168-e186. https://doi.org/10.1097/aog.0000000000002351

Daniels K, Arafeh J, Clark A, Waller S, Druzin M, Chueh J. Prospective randomized trial of simulation versus didactic teaching for obstetrical emergencies. Simul Healthc. 2010 Feb;5(1):40-5. https://doi.org/10.1097/sih.0b013e3181b65f22

Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005 Jan;27(1):10-28. https://doi.org/10.1080/01421590500046924

Fransen AF, van de Ven J, Banga FR, Mol BWJ, Oei SG. Multi-professional simulation-based team training in obstetric emergencies for improving patient outcomes and trainees' performance. Cochrane Database Syst Rev. 2020 Dec 16;12(12):CD011545. https://doi.org/10.1002/14651858.cd011545.pub2

Walker DM, Cohen SR, Fritz J, Olvera-García M, Zelek ST, Fahey JO, Romero-Martínez M, Montoya-Rodríguez A, Lamadrid-Figueroa H. Impact Evaluation of PRONTO Mexico: A Simulation-Based Program in Obstetric and Neonatal Emergencies and Team Training. Simul Healthc. 2016 Feb;11(1):1-9. https://doi.org/10.1097/SIH.0000000000000106

Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. AMEE Guide No. 82. Med Teach. 2013 Oct;35(10):e1511-30. https://doi.org/10.3109/0142159x.2013.818632

Zendejas B, Brydges R, Wang AT, Cook DA. Patient outcomes in simulation-based medical education: a systematic review. J Gen Intern Med. 2013 Aug;28(8):1078-89. https://doi.org/10.1007/s11606-012-2264-5

Draycott T, Sibanda T, Owen L, Akande V, Winter C, Reading S, Whitelaw A. Does training in obstetric emergencies improve neonatal outcome? BJOG. 2006 Feb;113(2):177-82. https://doi.org/10.1111/j.1471-0528.2006.00800.x

Ayupovna PD, Saidabdullayevna SM, Djurabaevna SN, Shermuxamat o'g'li EN, Taxirovna BN. Fenofibrate in the complex treatment of complications of type 2 diabetic retinopathy. Spectrum Journal of Innovation, Reforms and Development. 2023;15:52-4.