Severe perineal tears are rare events, making it difficult for residents to receive adequate training.


Up to 65% of vaginal deliveries are complicated by some form of tear or episiotomy. Severe tears can lead to long-term complications; however, they are rare enough that residents have few opportunities to receive training from experienced obstetricians. Residents who receive simulation-based training have improved performance, but we do not currently have a model for 4th degree perineal tears.

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