title: Managing Obstetric Emergencies and Trauma (MOET) structured skills training in Armenia, utilising models and reality based scenarios.
abstract: BACKGROUND
  Mortality rates in Western Europe have fallen significantly over the last 50 years. Maternal mortality now averages 10 maternal deaths per 100,000 live births but in some of the Newly Independent States of the former Soviet Union, the ratio is nearly 4 times higher. The availability of skilled attendants to prevent, detect and manage major obstetric complications may be the single most important factor in preventing maternal deaths. A modern, multidisciplinary, scenario and model based training programme has been established in the UK (Managing Obstetric Emergencies and Trauma (MOET)) and allows specialist obstetricians to learn or revise the undertaking of procedures using models, and to have their skills tested in scenarios.
  
  
  METHODS
  Given the success of the MOET course in the UK, the organisers were keen to evaluate it in another setting (Armenia). Pre-course knowledge and practice questionnaires were administered. In an exploratory analysis, post-course results were compared to pre-course answers obtained by the same interviewer.
  
  
  RESULTS
  All candidates showed an improvement in post-course scores. The range was far narrower afterwards (167-188) than before (85-129.5). In the individual score analysis only two scenarios showed a non-significant change (cord prolapse and breech delivery).
  
  
  CONCLUSIONS
  This paper demonstrates the reliability of the model based scenarios, with a highly significant improvement in obstetric emergency management. However, clinical audit will be required to measure the full impact of training by longer term follow up. Audit of delays, specific obstetric complications, referrals and near misses may all be amenable to review.
authors.affiliation: Academic Department of Obstetrics & Gynaecology, North Staffordshire Hospital (NHS) Trust, Newcastle Road, Stoke on Trent, UK. richard@kogs.freeserve.co.uk
authors.forename: Richard B
authors.initials: RB
authors.lastname: Johanson
authors.forename: Vijay
authors.initials: V
authors.lastname: Menon
authors.forename: Ethel
authors.initials: E
authors.lastname: Burns
authors.forename: Eduard
authors.initials: E
authors.lastname: Kargramanya
authors.forename: Vardges
authors.initials: V
authors.lastname: Osipov
authors.forename: Musheg
authors.initials: M
authors.lastname: Israelyan
authors.forename: Karine
authors.initials: K
authors.lastname: Sargsyan
authors.forename: Sarah
authors.initials: S
authors.lastname: Dobson
authors.forename: Peter
authors.initials: P
authors.lastname: Jones
mesh_terms: D001136:Armenia; D004502:Education, Medical, Continuing / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D004630:Emergencies; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006176:Gynecology / Q000193:education; D006801:Humans; D008428:Maternal Mortality / Q000639:trends; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy