Simulation‐based team training for multi‐professional obstetric care teams to improve patient outcome: a multicentre, cluster randomised controlled trial

Fransen, AF Annemarie; Ven, Jean-Pierre van de; Schuit, Ewoud; Tetering, Aac van; Mol, BW; Oei, S.G.

doi:10.1111/1471-0528.14369

Cited by 73 publications

(90 citation statements)

References 48 publications

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“…A reduction in brachial plexus injury at birth was also found at a unit with regular multi-professional training on shoulder dystocia management [10]. A cluster randomized controlled trial performed in the Netherlands allocated 24 obstetric units to team training or not and no decreased rate of brachial plexus injury at birth was found in the intervention group [8]. The follow up time in that study was 1 year compared with 8 years in the present study, which might explain the diverting results.…”

Section: Discussionmentioning

confidence: 99%

“…When it comes to improved obstetric and neonatal outcomes, only a small percentage of reports primarily addresses clinical outcomes and results are inconsistent [7]. One multicenter randomized control trial from the Netherlands showed how a one-day, off-site, simulation-based team training did not reduce obstetric complications (low Apgar score, severe postpartum hemorrhage, trauma due to shoulder dystocia, eclampsia, hypoxic ischemic encephalopathy) [8]. In contrast an Australian retrospective cohort study reported an overall improvement in some clinical outcomes (Apgar at 1 minute, umbilical cord lactate, and average length of infant’s stay in clinic) after a single day of training for the trainers at eight different maternity units [9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ten years of simulation-based shoulder dystocia training- impact on obstetric outcome, clinical management, staff confidence, and the pedagogical practice - a time series study

Dahlberg

Nelson

Dahlgren

et al. 2018

BMC Pregnancy Childbirth

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BackgroundTo assess the impact of 10 years of simulation-based shoulder dystocia training on clinical outcomes, staff confidence, management, and to scrutinize the characteristics of the pedagogical practice of the simulation training.MethodsIn 2008, a simulation-based team-training program (PROBE) was introduced at a medium sized delivery unit in Linköping, Sweden. Data concerning maternal characteristics, management, and obstetric outcomes was compared between three groups; prePROBE (before PROBE was introduced, 2004–2007), early postPROBE (2008–2011) and late postPROBE (2012–2015). Staff responded to an electronic questionnaire, which included questions about self-confidence and perceived sense of security in acute obstetrical situations. Empirical data from the pedagogical practice was gathered through observational field notes of video-recordings of maternity care teams participating in simulation exercises and was further analyzed using collaborative video analysis.ResultsThe number of diagnosed shoulder dystocia increased from 0.9/1000 prePROBE to 1.8 and 2.5/1000 postPROBE. There were no differences in maternal characteristics between the groups. The rate of brachial plexus injuries in deliveries complicated with shoulder dystocia was 73% prePROBE compared to 17% in the late postPROBE group (p > 0.05). The dominant maneuver to solve the shoulder dystocia changed from posterior arm extraction to internal rotation of the anterior shoulder between the pre and postPROBE groups. The staff questionnaire showed how the majority of the staff (48–62%) felt more confident when handling a shoulder dystocia after PROBE training. A model of facilitating relational reflection adopted seems to provide ways of keeping the collaboration and learning in the interprofessional team clearly focused.ConclusionsTo introduce and sustain a shoulder dystocia training program for delivery staff improved clinical outcome. The impaired management and outcome of this rare, emergent and unexpectedly event might be explained by the learning effect in the debriefing model, clearly focused on the team and related to daily clinical practice.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2001-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ten years of simulation-based shoulder dystocia training- impact on obstetric outcome, clinical management, staff confidence, and the pedagogical practice - a time series study

Dahlberg

Nelson

Dahlgren

et al. 2018

BMC Pregnancy Childbirth

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“…Recent narrative reviews have highlighted the common elements in effective obstetric training and these include: training as a compulsory institution-led requirement; highfidelity simulation models; and multi-disciplinary attendance [51,52]. Not all training is associated with improved clinical outcomes [53,54] so training must be rigorously and robustly evaluated for real-world effects.…”

Section: Approaches To Skills Training (Heading A)mentioning

confidence: 99%

“…This is thought to be related to learning in communities of practice and normalising practice based tools, rather than the transfer of completely new skills and ideas [53]. This compare to training in central simulation centres has not been associated with improvements in clinical outcomes [54,55]. Studies specifically focussing on local obstetric emergency training in settings within the UK, Australia, the USA and Zimbabwe have identified significant improvements in real-life neonatal outcomes including reductions in low Apgar scores, hypoxic-ischaemic encephalopathy and brachial plexus injury [26,46,56,57].…”

Section: Local Versus Distance Training (Heading B)mentioning

confidence: 99%

Skills training for operative vaginal birth

Hotton

O’Brien

Draycott

2019

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…In der Gesamtzahl nahmen die geburtshilflichen Komplikationen durch simulationsbasiertes Zwischenfallmanagement nicht ab. In dieser Studie nahm niemand aus den anaesthesiologischen Berufsgruppen teil und der Notfallkaiserschnitt war kein Trainingsszenario [26]. Für ihre Arbeit zur Reduktion von Zwischenfällen auf der Intensivstation haben Haerkens et al über 7200 Patienten eingeschlossen [21].…”

Section: Ergebnisseunclassified

Subjektiver Kompetenzgewinn zur Durchführung eines Notfallkaiserschnitts mittels interdisziplinärem Simulationstraining

Flentje

Schott

Woltemate

et al. 2017

Z Geburtshilfe Neonatol

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The emergency caesaran section is a gynecological emergency situation which is potentially life-threatening for mother and child. In the management of these time-critical situations human factors as well as the competence of the crisis resource management team have been shown to be important factors for success. The concept "simulation" has not been validated as a training tool for professional competence of multidisciplinary teams in the delivery suite. The aim of this study was, to assess the competence gain by subjective evaluation of the team members after taking part in an emergency caesarian section training which is integrable into the daily clinic setting. 36 members of a multidisciplinary team of a delivery suite took part in a 4-hourly "high-fidelity" simulation training "emergency caesarian section". Scenarios were created around the case setting of eclampsia with bradycardia of the child, uterus rupture, placenta abruption and cord prolapse. Each participant was involved in 2 scenarios as either a spectator or a team member. Using a questionnaire, the course performance and debriefing were evaluated and the subjective professional competence in Crisis Resource Management were recorded. In the collective of the trainee (over/equal 5 years), 25% had no experience in any cases of emergency caesarean in practice. On a scale of 1 to 6 (1=very good, 6=fail) the course was given an overall mark of 1.4 and a mark of 1.8 for its relevance to daily work. 6 months after the training, participants rated their competencies in prioritising necessary actions, following treatment plans, communicating among the team members as well as integrating new information as significantly improved. The 4-hour simulation training can be easily integrated into everyday clinical practice. The participants marked the course scenarios as realistic and relevant for their clinical practice. The number of years of prior work experience is not significanty related with the experience in rare emergency situations. The interdisciplinary team training is a way to improve individual performance as well as to establish and practise interdisciplinary emergency concepts.

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Simulation‐based team training for multi‐professional obstetric care teams to improve patient outcome: a multicentre, cluster randomised controlled trial

Abstract: 1-day, off-site, simulation-based team training did not reduce a composite of obstetric complications.

Cited by 73 publications

References 48 publications

Ten years of simulation-based shoulder dystocia training- impact on obstetric outcome, clinical management, staff confidence, and the pedagogical practice - a time series study

Ten years of simulation-based shoulder dystocia training- impact on obstetric outcome, clinical management, staff confidence, and the pedagogical practice - a time series study

Skills training for operative vaginal birth

Subjektiver Kompetenzgewinn zur Durchführung eines Notfallkaiserschnitts mittels interdisziplinärem Simulationstraining

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