# Evaluation of Knowledge, Attitude, and Practices of Compulsory Rotating Medical Interns in Managing Obstetric Emergencies in a Tertiary Hospital

## TL;DR

This study evaluates how well medical interns in India manage obstetric emergencies and finds that training and experience improve their preparedness.

## Contribution

The study provides a structured evaluation of interns' readiness for obstetric emergencies in an Indian tertiary hospital setting.

## Key findings

- Most interns showed adequate knowledge and positive attitudes toward managing obstetric emergencies.
- Formal training and prior exposure significantly improved interns' preparedness.
- Simulation-based training is recommended to enhance clinical proficiency among interns.

## Abstract

Background

Obstetric emergencies such as postpartum haemorrhage (PPH), eclampsia, and shoulder dystocia remain major causes of maternal mortality in low- and middle-income countries. The preparedness of frontline providers, including Compulsory Rotatory Medical Interns (CRMIs), is critical in preventing avoidable maternal deaths. Simulation-based obstetric emergency training has demonstrated global success in improving clinical competence; however, structured evaluation of interns’ readiness in Indian tertiary settings remains limited. This study was conducted to assess the knowledge, attitude, and practices (KAP) of CRMIs regarding obstetric emergency management and to identify factors influencing preparedness.

Methods

A hospital-based cross-sectional study was conducted among 100 CRMIs in a tertiary care teaching institution. Data were collected using a validated semi-structured questionnaire assessing demographic characteristics, knowledge of key obstetric emergencies, attitude toward team-based care, and self-reported clinical practices. Statistical analysis included descriptive proportions and association testing using chi-square and odds ratios with 95 % confidence intervals. Ethical clearance and informed consent were obtained.

Results

The mean age of participants was 24.1 ± 1.2 years, and 54 interns (54%) were females. A total of 70 interns (70%) were currently posted in obstetrics, while 83 (83%) had previously completed an obstetrics and gynaecology (OBG) posting. Formal training in obstetric emergencies had been undertaken by 79 interns (79%). Overall, 84 interns (84%) demonstrated adequate knowledge, 86 (86%) showed a positive attitude, and 74 (74%) exhibited good practice in managing obstetric emergencies. Knowledge adequacy showed significant associations with current OBG posting (47/70; p = 0.047), prior posting (75/83; p = 0.043), formal training (67/79; p = 0.021), and higher exposure to obstetric emergencies (approx. 56/70; p = 0.035).

Conclusion

The study demonstrates encouraging preparedness among CRMIs for managing obstetric emergencies, particularly among those with structured training and repeated exposure. Integrating mandatory simulation-based obstetric emergency programmes such as Advanced Life Support in Obstetrics (ALSO) or Basic Life Support in Obstetrics (BLSO) before CRMI posting is strongly recommended to bridge the gap between theoretical knowledge and hands-on clinical proficiency. Institutional adoption of periodic drills and refresher training will further strengthen emergency readiness and support national maternal-health goals.