Using Simulation to Study Difficult Clinical Issues

Geurtzen, Rosa; Hogeveen, Marije; Rajani, Anand K.; Chitkara, Rajinder K.; Antonius, Tim; Heijst, Arno van; Draaisma, Jos M. Th.

doi:10.1097/sih.0000000000000011

Cited by 20 publications

(24 citation statements)

References 29 publications

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“…Among the studies included in the review, there were five randomized studies [ 28 , 30 – 32 , 34 ] and four nonrandomized studies [ 26 , 27 , 29 , 33 ]. As reported in Table 2 , two randomized studies [ 30 , 31 ] did not reveal significant risks of bias based on the Cochrane quality assessment tool [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Quality assessment of nonrandomized studies based on the MINORS tool [ 25 ] is also reported in Table 2 . More in detail, all the nonrandomized studies [ 26 , 27 , 29 , 33 ] clearly described the aim (item 1). Only one study considered a consecutive sample of participants, while the others focused on a convenience sample or did not report the information (item 2).…”

Section: Resultsmentioning

confidence: 99%

“…Only one study considered a consecutive sample of participants, while the others focused on a convenience sample or did not report the information (item 2). Two studies recruited a non-real world sample of patients [ 29 , 33 ]. All the studies followed a protocol established before the beginning of the study (item 3) and included appropriate endpoints (item 4).…”

Section: Resultsmentioning

confidence: 99%

“…Only one study [ 29 ] reported a sample size calculation (item 8). All the domains concerning the comparative studies [ 29 , 33 ] were rated as adequate (items 9 through 12).…”

Section: Resultsmentioning

confidence: 99%

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Counselling about the Risk of Preterm Delivery: A Systematic Review

Pedrini

Prefumo

Frusca

et al. 2017

BioMed Research International

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We aimed to describe the outcomes of counselling for preterm delivery. PubMed, Embase, and PsycInfo were systematically searched (from 2000 to 2016) using the following terms: counselling, pregnancy complications, high-risk pregnancy, fetal diseases, and prenatal care. A total of nine quantitative studies were identified, five randomized and four nonrandomized. All studies were conducted in the USA, and half of them were based on a simulated counselling session. Two main clinical implications can be drawn from the available studies: firstly, providing written information before or during the consultation seems to have a positive effect, while no effect was detected when written material was provided after the consultation. Secondly, parents' choices about treatment seemed to be influenced by spiritual-related aspects and/or preexisting preferences, rather than by the level of detail or by the order with which information was provided. Therefore, the exploration of parents' beliefs is crucial to reduce the risks of misconception and to guarantee choice in line with personal values. More research is necessary to validate these findings in cross-cultural contexts and in real world settings of care. Moreover, the centeredness of conversations and the characteristics of the clinician involved in counselling should be addressed in future studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Only one study [ 29 ] reported a sample size calculation (item 8). All the domains concerning the comparative studies [ 29 , 33 ] were rated as adequate (items 9 through 12).…”

Section: Resultsmentioning

confidence: 99%

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Counselling about the Risk of Preterm Delivery: A Systematic Review

Pedrini

Prefumo

Frusca

et al. 2017

BioMed Research International

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“…Opinions on how to perform prenatal counseling diverge among individual professionals [21, 22, 28]. Earlier, it has been demonstrated that actual prenatal counseling practices appear to be very heterogeneous, within and between countries [1, 6, 12–14, 34, 37, 50]. However, since the outcome of counseling has major impact on life or death decisions, practice variation is unwanted when it is not based on fetal or parental characteristics.…”

Section: Introductionmentioning

confidence: 99%

Professionals’ preferences in prenatal counseling at the limits of viability: a nationwide qualitative Dutch study

Geurtzen¹,

Heijst²,

Draaisma³

et al. 2017

Eur J Pediatr

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Prenatal counseling practices at the limits of viability do vary, and constructing a counseling framework based on guidelines, professional and parental preferences, might achieve more homogeneity. We aimed to gain insight into professionals’ preferences on three domains of counseling, particularly content, organization, and decision making and their influencing factors. A qualitative, nationwide in-depth exploration among Dutch perinatal professionals by semi-structured interviews in focus groups was performed. Regarding content of prenatal counseling, preparing parents on the short-term situation (delivery room care) and revealing their perspectives on “quality of life” were considered important. Parents should be informed on the kind of decision, on the difficulty of individual outcome predictions, on survival and mortality figures, short- and long-term morbidity, and the burden of hospitalization. For organization, the making of and compliance with agreements between professionals may promote joint counseling by neonatologists and obstetricians. Supportive materials were considered useful but only when up-to-date, in addition to the discussion and with opportunity for personalization. Regarding decision making, it is not always clear to parents that a prenatal decision needs to be made and they can participate, influencing factors could be, e.g., unclear language, directive counseling, overload of information, and an immediate delivery. There is limited familiarity with shared decision making although it is the preferred model. Conclusion: This study gained insight into preferred content, organization, and decision making of prenatal counseling at the limits of viability and their influencing factors from a professionals’ perspective. What is Known: • Heterogeneity in prenatal counseling at the limits of viability exists • Differences between preferred counseling and actual practice also exists What is New: • Insight into preferred content, organization, and decision making of prenatal periviability counseling and its influencing factors from a professionals’ perspective. Results should be taken into account when performing counseling. • Particularly the understanding of true shared decision making needs to be improved. Furthermore, implementation of shared decision making in daily practice needs more attention.

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