Evaluation and impact of cardiotocography training programmes: a systematic review

Abstract

Background The interpretation and management of cardiotocography (CTG) tracings are often criticised in obstetric malpractice cases. As a consequence, regular CTG training has been recommended, even though little is known about the effect of CTG training.Objectives To perform a systematic review of the existing literature on studies on CTG training in order to assess educational strategies, evaluation of training programmes, and impact of training programmes.Search strategy The Medline database was searched to identify studies describing and/or evaluating CTG training programmes. The literature search resulted in 409 citations.Selection criteria Twenty studies describing and evaluating CTG training programmes were included. There was no restriction on study design.Data collection and analysis Data regarding study design, study quality, educational strategies used for training in CTG interpretation and decision making, target groups, number of participants, methods used for evaluation, quality of evaluation, level of evaluation and results of training was extracted from 20 articles, and analysed using Kirkpatrick's four-level model for the evaluation of education.Main results Training was associated with improvements on all Kirkpatrick levels, resulting in increased CTG knowledge and interpretive skills, higher interobserver agreement, better management of intrapartum CTG, and improved quality of care. Computer-based training (CBT) might be less time-consuming than classroom teaching. Clinical skills seem to decrease faster than theoretical knowledge.Author's conclusions Training can improve CTG competence and clinical practise. Further research on CBT, test-enhanced learning and long-term retention, evaluation of training and impact on clinical outcomes is recommended.

Results from the National Perinatal Patient Safety Program in Sweden: the challenge of evaluation

“…comm.). A systematic review of educational strategies suggests that interpretive skills do improve after training . In contrast, in a previous study, we found no improvement in the proportion of individuals who classified CTGs correctly after the completion of the program, possibly reducing the incentive to implement the education program .…”

Expert midwives experiences of security in their professional practice: Im the captain of a jet

“…Dekert et al (2010) hold that practical training improves learning and increases selfconfidence. Pehrson et al (2011) found that training can improve knowledge of cardiotocography (CTG), leading to better quality care. Team training courses (Beasley, 2005) improve the maternity team's knowledge and practical skills, resulting in greater structure in acute situations as well as security.…”

The impact of a national cardiotocography education program on neonatal and maternal outcomes: A historical cohort study

“…Suggestions for improvement in CTG education have been proposed to overcome human errors in CTG management with the hope that improvements in neonatal outcomes would ensue . Although several studies conclude that CTG education leads to improved CTG knowledge and interpretation skills, few studies have evaluated the concomitant effect on neonatal outcomes and the results of these studies diverge …”