Introduction:
More than half of all women who give birth vaginally suffer a perineal injury requiring care. The skills of midwives and obstetricians in diagnosis and suturing have a great influence on the physical and emotional well-being of the women for the rest of their lives.

Material and Methods:
GynZone has developed blended learning scenarios for midwives and obstetricians. The online course platform contents convey all necessary procedures, step by step. Measures are explained in three levels of complexity, in awareness that the real field of operation is not as simple as a scientific graphic. In addition, GynZone offers regular hands-on workshops because the opportunity to acquire clinical skills through traditional textbooks or e-learning is notoriously limited. In order to make simulation training widely accessible for learners, we need training models as close as possible to the anatomical structures but also to be accessible, durable and sustainable, and the per-simulation cost to be low.

Results:
Our team of expert midwives and obstetricians has developed woman-friendly, cruelty free, medical models for 1st through 4th-degree perineal injuries. Our blended learning strategies include access to GynZones e-learning with animated videos, simulation training instructions with medical models, and surgery videos with real patients before the hands-on training on medical models. The outcome of the surgical training sessions can be improved by 40% through further continuous training and reflection. The learners will practice their skills by suturing through a design on low fidelity, take-home training models, which are lightweight, low cost, and represents the important anatomy for the task. The models can be adapted to the requirements of increasing learning levels, from stress-free home training, to science labs, peer group work, and complex postpartum situations.

Conclusion sustainable:
Never first on a patient: We want learners to have an adequate level of skills and competence, before suturing a living person for the first time. After more than 15 years experience, we have learned that the reality of our teaching requires models must adapt to the competence of beginners and not be too sophisticated and expensive for that. In addition, they must be able to be used in different learning levels and settings.