Advancing Assisted Vaginal Birth Training Through Simulation

OdonAssist: A Journey from Research to Clinical Practice. Article by Dr Emily Hotton, Obstetrics and Gynaecology Resident Doctor.

The development of new maternity devices requires more than clinical innovation alone. It also depends on safe evaluation, effective training and a clear route into clinical practice. This article explores how simulation has supported the development and introduction of OdonAssist™, while helping clinicians build the skills and confidence needed for assisted vaginal birth.

"As a clinician with a long-standing interest in improving assisted vaginal birth (AVB) training, I have been fortunate to work alongside colleagues from Limbs & Things, Maternal Newborn Health Innovation (MNHI), and the wider maternity research community over many years. Looking back, what stands out is how simulation has connected each stage of the journey—from early research and device development through to clinician training and implementation in practice.

The story began with the early development of what would eventually become the OdonAssist™ device. Long before the device entered clinical practice, the Limbs & Things PROMPT Flex manikin was used to explore, test and refine the concept in a simulated environment. Simulation studies, including the work published by O'Brien and colleagues in 2017, helped shape the device's development and demonstrated the value of simulation as a safe space in which new ideas could be evaluated and improved before being introduced into clinical care.

My own involvement came later during the ASSIST UK studies at Southmead Hospital, Bristol, where I was an investigator exploring the novel OdonAssist device in clinical trials. By then, I had already seen the value of simulation in supporting clinical education, and the PROMPT Flex simulator proved invaluable for training, skills development and standardisation across research teams. It reinforced how simulation could support not only education, but also the rigorous evaluation of new approaches to care.

"What started as simulation work supporting assisted vaginal birth research ultimately helped shape a new device, a new training platform, and a global training programme."

Building on those experiences, I worked with Limbs & Things in 2019 to develop the AVB Module for the PROMPT Flex simulator. Our goal was to create a dedicated, high-fidelity platform that would allow clinicians to practise and refine assisted vaginal birth techniques in a realistic but controlled environment.

As OdonAssist continued its development journey, simulation remained central to its evaluation and implementation. Following CE marking in 2025, MNHI adopted the PROMPT Flex simulator and AVB Module as the platform for delivering OdonAssist training programmes across the world. This has enabled clinicians to gain hands-on experience with the device through structured simulation before introducing it into clinical practice.

For me, this story is about much more than a collaboration between organisations. It demonstrates how research, simulation and innovation can work together over many years to address unmet clinical needs. From the earliest simulation testing of OdonAssist, through the ASSIST studies and the development of the AVB Module, to clinician training across Europe, simulation has been the thread connecting research, education and patient care.

I am proud to have contributed to part of that journey and look forward to seeing how simulation continues to support the next generation of innovation in maternity care."