What is the impact of multi-professional emergency obstetric and neonatal care training?

Abstract

This paper reviews evidence regarding change in healthcare-provider behaviour and maternal and neonatal outcomes as a result of emergency obstetric and neonatal care (EmONC) training. A refined version of the Kirkpatrick classification for programme evaluation was used to focus on change in efficiency and impact of training (levels 3 and 4). Twenty-three studies were reviewed -5 randomised controlled trials, 2 quasi-experimental studies and 16 before-and-after observational studies. Training programmes had all been developed in highincome countries and adapted for use in low-and middle-income countries. Nine studies reported on behaviour change and 13 on process and patient outcomes. Most showed positive results. Every maternity unit should provide EmONC teamwork training, mandatory for all healthcare providers. The challenges are: scaling up such training to all institutions; sustaining regular in-service training; integrating training into institutional and health-system patient-safety initiatives; and 'thinking-out-of-the-box' in evaluation research.

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

“…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]. …”

“…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.…”

“…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.…”

“No patient should die of PPH just for the lack of training!” Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study

“…Simulation training, which allows health workers to train on skills and drills without harming the patient, has become the preferred tool for team training to enhance patient safety [16, 17]. However, the success of simulation training is likely to depend on how the design of the training takes into account salient learning features.…”

A rapid cycle method for local adaptation of an obstetric emergencies training program

“…The delay in receiving adequate care in a clinical setting could reflect suboptimal training of maternity staff in the management of obstetric emergencies. A promising strategy to reduce preventable harm is the use of a structured local multi‐professional training program for obstetric emergencies . This approach has been recommended by various national bodies for more than 20 years .…”