title: Multidisciplinary obstetric simulated emergency scenarios (MOSES): promoting patient safety in obstetrics with teamwork-focused interprofessional simulations.
abstract: BACKGROUND
  We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined.
  
  
  METHODS
  Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England. Telephone or e-mail interviews with MOSES course participants and facilitators were conducted, and video-recorded debriefings that formed integral parts of this 1-day course were analyzed.
  
  
  RESULTS
  The team training was well received. Participants were able to check out assumptions and expectations of others and develop respect for different roles within the delivery suite (DS) team. Skillful facilitation of debriefing after each scenario was central to learning. Participants reported acquiring new knowledge or insights, particularly concerning the role of communication and leadership in crisis situations, and they rehearsed unfamiliar skills. Observing peers working in the simulations increased participants' learning by highlighting alternative strategies. The learning achieved by individuals and groups was noticeably dependent on their starting points. Some participants identified limited changes in their behavior in the workplace following the MOSES course. Mechanisms to manage the transfer of learning to the wider team were weakly developed, although 2 DS teams made changes to their regular update training.
  
  
  CONCLUSIONS
  Interprofessional, team-based simulations promote new learning.
authors.affiliation: School of Community and Health Sciences, City University, London, UK. d.s.freeth@city.ac.uk
authors.forename: Della
authors.initials: D
authors.lastname: Freeth
authors.forename: Gubby
authors.initials: G
authors.lastname: Ayida
authors.forename: Emma Jane
authors.initials: EJ
authors.lastname: Berridge
authors.forename: Nicola
authors.initials: N
authors.lastname: Mackintosh
authors.forename: Beverley
authors.initials: B
authors.lastname: Norris
authors.forename: Chris
authors.initials: C
authors.lastname: Sadler
authors.forename: Alasdair
authors.initials: A
authors.lastname: Strachan
mesh_terms: D002983:Clinical Competence; D004632:Emergency Medical Services; D004739:England; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D019300:Medical Errors / Q000517:prevention & control; D009774:Obstetrics / Q000193:education*; D015397:Program Evaluation; D017751:Safety Management; D013663:Teaching / Q000379:methods*