Purpose
Midwifery students must learn to manage obstetric emergencies like shoulder dystocia. This may be difficult to learn using 2D visuals alone. Shoulder dystocia occurs during vaginal birth when either fetal shoulder becomes obstructed at the pubic bone, thus requiring prompt recognition and clinical intervention. During simulation training, students must learn specific hand maneuvers to resolve the obstruction without causing harm. Gaps in learners' spatial understanding of the pelvis can lead to difficulties inserting the correct hand or identifying fetal orientation and landmarks critical for effective intervention. To address these challenges, our team developed a 3D animation demonstrating shoulder dystocia and its management using the all-fours position and the posterior arm maneuver. We highlight these maneuvers as they are the most effective in safely dislodging the fetal shoulders.

Methods
We surveyed and interviewed midwifery students to identify challenges in learning how to manage shoulder dystocia. The University of British Columbia (UBC) Hackspace for Innovation and Visualization in Education (HIVE) provided an anatomically correct fetus and pelvis model for modification. Using the 3D software Blender, we modeled a pair of clinician hands and compiled an instructional animation that includes visual aids and captions.

Results
Our animation shows the fetus completing the mechanisms of labour in an upright position. The pathology of shoulder dystocia is highlighted as the fetal shoulder impacts the pelvis. The fetus and pelvis are then rotated into an all-fours position followed by the removal of the posterior arm with the correct hand safely dislodging the arm based on fetal positioning. To enhance visualization, we modelled the hands and the pelvis to be semitransparent, addressing common learning obstacles identified in our user research and testing.

Conclusions
Our animation addresses spatial learning gaps and can be used as a supplement to midwifery curriculum and anatomy education. Future iterations could include interactivity and additional clinical maneuvers to further improve training and comprehension.