Myths and realities of training in obstetric emergencies

Draycott, Timothy; Collins, Katherine J.; Crofts, Joanna F.; Siassakos, Dimitrios; Winter, Cathy; Weiner, Carl P.; Donald, Fiona

doi:10.1016/j.bpobgyn.2015.07.003

Cited by 51 publications

(40 citation statements)

References 75 publications

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“…The current evidence base suggests the use of local, inter-professional, in situ training provided to all staff in maternity care units. [5][6][7] Simulation training has been recognised as a valuable tool to improve not only knowledge and clinical skills, but also to improve communication and teamwork during the management of obstetric emergencies, and has been shown to lead to improved perinatal outcomes. [8][9][10] In-house training in particular is associated with improved outcomes 5 and the utilisation of training in remote and rural sites is an issue with obvious relevance to the Australian healthcare paradigm.…”

Section: Resultsmentioning

confidence: 99%

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

Whitelaw

Calvert

Epee

2017

Aust NZ J Obst Gynaeco

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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.

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Section: Resultsmentioning

confidence: 99%

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

Whitelaw

Calvert

Epee

2017

Aust NZ J Obst Gynaeco

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“…Assessing participants individually may be relevant and participants who have been tested have been shown to have better retention as a result of what is known as the testing effect [36]. However, some simulation participants may experience that being assessed disrupts the feeling of being in a safe learning environment [37]. Developing a test to be applied in an inter-professional context will, in addition to curriculum development, require the involvement of all the healthcare professional groups that are part of the simulation intervention [38].…”

Section: Discussionmentioning

confidence: 99%

“…Practicing teamwork integrated with simulation-based skills training that encompasses a clinical approach is preferable and has been shown to be associated with significant improvements [37, 58, 63, 64]. …”

Section: Discussionmentioning

confidence: 99%

“…Further this might help to guarantee that simulation instructors are sufficiently trained, in addition to encouraging and coordinating simulation research [45, 46]. Research on inter-professional postgraduate simulation shows that simulation conducted in close proximity to the clinical setting has a positive impact and that the departments involved gain useful organisational information for improving care [20, 21, 23, 27, 28, 37, 58, 63, 64], which are arguments for incorporating simulation facilities in new hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on postgraduate inter-professional training show that local training, such as announced and unannounced ISS or OSS in-house, offers various advantages, e.g. locally run courses benefit local organisational learning, reduce costs and increase the accessibility of training for professional staff [37, 58, 63, 64]. Some of the potential disadvantages of holding courses locally can be organisational problems and poor quality content due to badly organised simulations and a lack of qualified simulation instructors.…”

Section: Discussionmentioning

confidence: 99%

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Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation

et al. 2017

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BackgroundSimulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care units with healthcare professionals in their own working environment. Thus, this intentional blend of simulation and real working environments means that in situ simulation brings simulation to the real working environment and provides training where people work. In situ simulation can be either announced or unannounced, the latter also known as a drill. This article presents and discusses the design of SBME and the advantage and disadvantage of the different simulation settings, such as training in simulation-centres, in-house simulations in hospital departments, announced or unannounced in situ simulations.DiscussionNon-randomised studies argue that in situ simulation is more effective for educational purposes than other types of simulation settings. Conversely, the few comparison studies that exist, either randomised or retrospective, show that choice of setting does not seem to influence individual or team learning. However, hospital department-based simulations, such as in-house simulation and in situ simulation, lead to a gain in organisational learning. To our knowledge no studies have compared announced and unannounced in situ simulation. The literature suggests some improved organisational learning from unannounced in situ simulation; however, unannounced in situ simulation was also found to be challenging to plan and conduct, and more stressful among participants. The importance of setting, context and fidelity are discussed.SummaryBased on the current limited research we suggest that choice of setting for simulations does not seem to influence individual and team learning. Department-based local simulation, such as simulation in-house and especially in situ simulation, leads to gains in organisational learning. The overall objectives of simulation-based education and factors such as feasibility can help determine choice of simulation setting.

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Obstetric Emergencies

Paterson‐Brown

Draycott

2018

Dewhurst's Textbook of Obstetrics &Amp; Gynaecology

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Myths and realities of training in obstetric emergencies

Cited by 51 publications

References 75 publications

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

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

Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation

Obstetric Emergencies

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