The Use of Simulation to Teach Clinical Skills in Obstetrics

Cass, Gemma; Crofts, Joanna F.; Draycott, Timothy

doi:10.1053/j.semperi.2011.01.005

Cited by 48 publications

(43 citation statements)

References 37 publications

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“…We first performed an extensive literature review about NTS in healthcare, focusing specifically on the professions involved in delivery room simulation [1, 2, 17, 21–24]. The NTS observation tool for anaesthetists was the only suitable tool for our study already available in literature [25].…”

Section: Methodsmentioning

confidence: 99%

“…The key feature of skilled feedback is its capacity to involve the participants in reflecting on the performance without feeling judged or ashamed. Whenever the learners feel the pressure of judgement, their cognitive resources are dramatically devoted to defending themselves instead of integrating the experience into theoretical frames and professional procedures [17, 18]. An adequate method for providing effective feedback during debriefings is focusing on the behaviours observed during the simulated scenario, because any comment will be specific and will refer to actions instead of talking about the person as a whole.…”

Section: Introductionmentioning

confidence: 99%

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Adaptation of non-technical skills behavioural markers for delivery room simulation

Bracco

Masini

Tonetti

et al. 2017

BMC Pregnancy Childbirth

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BackgroundSimulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room).MethodsThe MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected.ResultsThe mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories.ConclusionThe MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1274-z) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adaptation of non-technical skills behavioural markers for delivery room simulation

Bracco

Masini

Tonetti

et al. 2017

BMC Pregnancy Childbirth

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“…Using simulation as a proxy to assess clinical skills could be argued to be a suboptimal level of evaluation, as an improvement in simulation skills may not necessarily translate into an improvement in clinical skills. However, the obstetric community has previously embraced simulation-based outcomes as applicable in the clinical setting [17] and is likely to continue to do so regarding instrumental delivery training.…”

Section: Discussionmentioning

confidence: 99%

Novel Simulation Workshop Improves Performance in Vacuum Delivery

Calvert¹,

Epee²,

Karzcub³

et al. 2016

OJOG

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Background: Operative vaginal delivery is a common obstetric intervention, with the potential to cause harm to mother and baby. Training in operative delivery traditionally comprised junior trainees learning the skills under supervision, then practicing and refining them independently. Recently this model has come under scrutiny, with the advent of simulation-based training suggesting a method by which the skills of safe delivery may be taught without risk. Multiple training courses exist, but few have been subjected to evaluation. Aims: The primary aim was to investigate if a simulation-based training workshop, where the development of a successful technique for vacuum delivery occurs using a collaborative, problem-solving approach, improves the rate of correct vacuum cup placement. The secondary aim was to determine if the workshop leads to improvement in theoretical knowledge of vacuum delivery. Methods: Participants on three workshops were assessed for their performance in vacuum delivery prior to and following a multimodal training program. Participants included general practitioner obstetricians, obstetric trainees and resident medical officers. Evaluation occurred using a standardised Likert-scaled rating sheet and utilising a diagrammatic representation of cup placement. Results: The participants demonstrated significant improvement (median post-pre score 1, p < 0.001) in the accuracy of cup placement, in a variety of practical core skills and in theoretical knowledge of vacuum delivery. Discussion: Participation in a simulation-based vacuum delivery workshop improves the performance of obstetric trainees and GP obstetricians. Further work is required to evaluate the performance of such training modalities on clinically relevant outcomes.

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“…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. Cass et al (2011) claimed that practical training can contribute to improved maternal and neonatal outcome. Secure team members mediate a sense of security, in turn leading to more secure midwives, which also reflect on their colleagues.…”

Section: Discussionmentioning

confidence: 99%

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

Högeryd¹,

Berndtsson²,

Lyckhage³

2014

Int. J. Nurs. Midwifery

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Obstetric units have become larger, with patients being knowledgeable and demanding. Also, established team works at maternity wards require that midwives are secure in their role. A descriptive study with a phenomenological approach was used. A maternity unit in a hospital located in Western Sweden was chosen. Five expert midwives with vast experience of obstetric care who worked in a maternity unit were interviewed. Data were collected by audio-taped interviews. The data were analysed by means of Giorgi's phenomenological method. The results showed that security was constituted by an inherent sense of security as well as confidence in self and in life. Education and practical group training in the workplace provided theoretical knowledge and practical experience. Support for others in the working team and open communication also constituted security. Also, clear leadership, guidelines and routines provided a framework and had a positive effect on expert midwives' sense of security. When security was absent, midwife became worried, the joy and harmony diminished. In order to ensure midwife security and ultimately safe patient care, it was important to allow time for rest, to reflect on and evaluate their work. Expert midwives can create the prerequisites for their professional security. Several constituents combine to shape midwives' sense of professional security; an inherent sense of security, own knowledge and experience, team collaboration, visible and clear leadership.

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The Use of Simulation to Teach Clinical Skills in Obstetrics

Cited by 48 publications

References 37 publications

Adaptation of non-technical skills behavioural markers for delivery room simulation

Adaptation of non-technical skills behavioural markers for delivery room simulation

Novel Simulation Workshop Improves Performance in Vacuum Delivery

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

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