The implementation and evaluation of a mandatory multi-professional obstetric skills training program.
OBJECTIVE. To implement and evaluate a simulation-based training program. DESIGN. Descriptive.


METHODS
June 2003-June 2006. SETTING. Obstetric Department, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. POPULATION. Two training sessions were provided for all health professionals including doctors, midwives, auxiliary nurses, and 147 out 156 participants (94%) took part in the first training session and 192 out possible 201 (96%) took part in the second session. METHODS. An intervention study of the impact of simulation-based training in management of postpartum bleeding, shoulder dystocia, basic neonatal resuscitation, and severe preeclampsia. MAIN OUTCOME MEASURES. Before, just after and 9-15 months following the training, data were collected on the confidence and stress levels relating to the carrying out of certain procedures. In addition, a written objective test on basic neonatal resuscitation was administered. Data on any changes in work-routines experienced by the participants were obtained by open-ended questions. Registry data from the Danish Medical Birth Registry and from the hospital administration were included in the analysis. RESULTS. Ninety-two percent of all respondents had a positive attitude toward the training program. They considered management of shoulder dystocia, preeclampsia, and neonatal resuscitation less stresful and less unpleasant to perform after training. Confidence scores for all the trained skills improved significantly. A significant association was found between confidence in neonatal resuscitation and numbers of correct answers in the objective test. More than 90% found the training to have had a positive influence on their work. The need for organizational changes in the department became evident and necessary changes were implemented. Sick leave amongst midwives diminished significantly during the study period. CONCLUSIONS. A comprehensive evaluation of a mandatory simulation-based program, implemented in a obstetric department, demonstrated a positive impact at individual and organizational levels.
Sørensen
Jette Led
JL
Obstetric Department, The Juliane Marie Center for Children, Women and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. jette.led.soerensen@rh.regionh.dk
Løkkegaard
Ellen
E
Johansen
Marianne
M
Ringsted
Charlotte
C
Kreiner
Svend
S
McAleer
Sean
S
D000328:Adult; D002983:Clinical Competence; D004420:Dystocia / Q000628:therapy; D005260:Female; D006801:Humans; D009774:Obstetrics / Q000193:education*; D016544:Patient Simulation; D011225:Pre-Eclampsia / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D016730:Program Development; D015397:Program Evaluation; D012042:Registries; D012151:Resuscitation