Keeping in time: Issues affecting the sustainability of obstetric emergency simulation training in outer metropolitan, rural and remote centres in Western Australia

Abstract

BackgroundObstetric emergency simulation training is an evidence‐based intervention for the reduction of perinatal and maternal morbidity. In Western Australia, obstetric emergency training has been run using the In Time course since 2006.AimsThe study aimed to determine if the provision of In Time train the trainer courses to outer metro, rural and remote units in Western Australia had led to sustained ongoing training in those units. Ten years following the introduction of the course, we performed a survey to examine which units are continuing to run In Time, what are the perceived benefits in units still utilising In Time, and what were the barriers to training in units that had discontinued.Materials and methodsA link to an online survey was sent to the units where In Time training had occurred. Telephone enquiries were additionally used to ensure a good response rate.ResultsThe survey response rate was 100%. Six of the 11 units where training had been provided continue to run In Time. Units where training had discontinued had done so in order to take up alternatives, or as a result of trainers leaving. Of the units who had discontinued training, one wished to recommence In Time.ConclusionsLocal in situ training in obstetric emergencies as exemplified by the In Time course remains a popular and valued training intervention across Western Australia. This training may be of particular benefit to small and remote units, but these are the areas in which training is hardest to sustain.

Validating the Team Emergency Assessment Measure (TEAM) in obstetric and gynaecologic resuscitation teams

“…18,20 Simulations can enhance non-technical skills; 2 however, their integration into health services is often hampered by the lack of instruments to assess team performance 9 and simulation experts. 8 The present study provides support for the use of the TEAM as a viable tool to assess team performance in obstetrics and gynaecology simulations. We sought to examine the utility of the TEAM in the obstetrics and gynaecology emergency context as a means of overcoming barriers to simulation-based training.…”

“…For many years, obstetric and gynaecologic emergency simulation training has been dependent on the availability of simulation experts, attenuating its accessibility and utility. 8 With this said, our results found no difference in the TEAM ratings between low and high experience raters, suggesting simulation expertise may not be requisite to effectively using the TEAM in obstetric and gynaecologic emergency simulation. On the surface, our results appear to contradict those of Freytag et al…”

“…15,29 Our results suggest very good inter-rater reliability across this large number of raters meaning the TEAM may be effectively used by groups of simulation observers. Such information is practically useful because the TEAM can be used in mass simulation-based education and perhaps even virtually due to working in remote areas 8 or the pandemic. 31 The ability to share an emergency simulation with many observers simultaneously while reflecting on their non-technical skills may contribute to reducing the financial burden of simulation training 8 thus enhancing access to this valuable educational tool.…”

“…7 Despite notable benefits, several barriers exist to simulation-based training in obstetrics and gynaecology. The most critical barriers concern feasibility issues including the lack of expert local educators 8 and malleable outcome measures of team performance. 9 One potential solution to these barriers is the use of a validated simulation tool that does not rely on extensive simulation experience to yield similar learning opportunities and is widely applicable to simulations of varying content.…”