The development and evaluation of a computer‐assisted teaching programme for intrapartum fetal monitoring

Abstract

Objective The development and evaluation of a computer-assisted teaching programme of cardiotocography and acid-base balance.Design Randomised controlled trial.Participants One hundred and seventeen midwifery and obstetric staff at Derriford Hospital, Plymouth.Methods The obstetricians and midwives were randomly allocated to use the teaching programme, either early or late. The late group (control) used the teaching programme three months after the early group.To assess the effect of the teaching programme, participants were tested on four occasions over eight months by a multiple choice questionnaire. Two questionnaires on ease of use were also completed. Main outcome measuresMultiple choice questionnaire scores and opinion questionnaire results. ResultsThe mean score in the early group improved from 504% (test 1, pre-teaching programme) to 70.2% (test 2, post-teaching programme). The mean score in the control group was 50.3% (test 1) and 54.8% (test 2). Knowledge was retained up to seven months. ConclusionsThe teaching programme was effective in improving knowledge of acid-base balance and cardiotocography and can be used by all staff whilst on duty on the labour ward.

“Every case of asphyxia can be used as a learning example”. Conclusions from an analysis of substandard obstetrical care

“…In an online educational setting in CTG and acid-base interpretation in the UK, the mean scores in written tests after education were around 63 % and 83 % for midwives and obstetricians, respectively, which indicates that additional efforts are needed. This has raised the question of whether a certain number of people might suffer from cognitive dysfunction resulting in pattern dyslexia [13] . If so, besides training and education, maybe CTG interpretation should routinely be assessed by at least two persons in the future, or by additional computerized interpretation functions to enable improved accuracy in CTG interpretation [26,73] .…”

“…Improvements can thus be achieved by introducing training programs [13,21,27,35] . When immediate delivery is requested due to imminent asphyxia, both obstetricians and midwives must be confident in their choice of the fastest and least injurious mode of delivery.…”

S1-Guideline on the Use of CTG During Pregnancy and Labor

“…Attendance at and participation in such training should therefore be encouraged ( [7,65]; EL II a). The use of electronic systems with integrated signal analysis (unremarkable, suspicious, pathological) is useful for education and training as the success of the training can be measured objectively before and after training (EL Ia).…”

Einfluss der CTG-Überwachung auf das klinische Outcome

“…Dies wurde durch rechnergestützte Schulungssysteme erleichtert, durch die das Wissen um das fetale Säure-Basen-Gleichgewicht unter der Geburt nachweislich verbessert werden kann [3]. Die Schulungs-und Bewertungssoftware hilft Ärzten oder Hebammen bei der Erweiterung ihres Wissens und der Verbesserung ihrer Interpretationsfähigkeit.…”