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We studied a random sample of four teams of doctors and midwives who participated in a videotaped simulated obstetric emergency, postpartum haemorrhage, before and after 'on-site' clinical training. We aimed to assess the validity of mixed techniques for the analysis of team communication and whether clinical and non-clinical team training improve communication. Two of the four teams received extra training in specific teamwork behaviours (TW+), the other half received only clinical training (TW-). We used content analysis to identify changes in communication patterns. There was a reduction in the total number of communications after training. Teams that received additional teamwork training used more directed commands after training. When commands were directed to specific individuals, tasks were more likely to be acknowledged and performed. We conclude that 'on-site' clinical drills can improve team communication in simulated emergencies, and additional teamwork training might improve this further, but it has to be refined and made obstetric specific first.

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ABSTRACT

Worldwide, donor-assisted conceptions are increasing with legislative reforms in some countries providing opportunities for participants of a donor-assisted conception programme, i.e. recipients, donors, donor-conceived adults and their genetically related siblings and half-siblings, to access information. Whilst policy and practice for accessing donor-identifying information vary, there has been no research exploring the perceptions and experiences of those who provide the service. This study aimed to explore the perceptions and experiences of Australian and New Zealand infertility counsellors who provide counselling for release of information to participants of a donor-assisted conception programme. Using a qualitative research design, in-depth interview data of six infertility counsellors were thematically analysed to identify key themes. We report the primary themes that emerged from the data which include professional perspectives on the role of counsellor in the counselling process, the professional and societal responsibility to provide counselling, and influences on professional practice. Findings from this qualitative study can be used as a platform for larger international studies on the clinical practice of donor information release and to inform clinical practice and service delivery. The implications of these results for policy and future longitudinal research are also discussed.

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ABSTRACT

An educational course for post-basic multi-cultural South African nurses, based on a model for critical reflective practice, forms the case study for a participatory action research paradigm that frames this qualitative study