title: Interdisciplinary simulation-based training to improve delivery room communication.
abstract: BACKGROUND
  Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams.
  
  
  METHODS
  Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008-2011 (Y1-Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance.
  
  
  RESULTS
  At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05).
  
  
  CONCLUSIONS
  Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.
authors.affiliation: From the Divisions of Neonatology (R.D., R.G.) and Hospital Medicine (J.S.), Department of Pediatrics, and Department of Obstetrics and Gynecology (J.W., C.A., C.D.G., E.C.C., E.K.P.), and Department of Biostatistics and Computational Biology (H.W.), University of Rochester Medical Center, Rochester, NY.
authors.forename: Rita
authors.initials: R
authors.lastname: Dadiz
authors.forename: Joanne
authors.initials: J
authors.lastname: Weinschreider
authors.forename: Jan
authors.initials: J
authors.lastname: Schriefer
authors.forename: Christine
authors.initials: C
authors.lastname: Arnold
authors.forename: Cole D
authors.initials: CD
authors.lastname: Greves
authors.forename: Erin C
authors.initials: EC
authors.lastname: Crosby
authors.forename: Hongyue
authors.initials: H
authors.lastname: Wang
authors.forename: Eva K
authors.initials: EK
authors.lastname: Pressman
authors.forename: Ronnie
authors.initials: R
authors.lastname: Guillet
mesh_terms: D057189:Checklist; D003696:Delivery Rooms / Q000458:organization & administration; D004502:Education, Medical, Continuing / Q000379:methods; D004509:Education, Nursing, Continuing / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration; D033183:Interdisciplinary Communication; D019370:Observation; D007744:Obstetric Labor Complications / Q000517:prevention & control / Q000628:therapy; D009774:Obstetrics / Q000193:education* / Q000592:standards; D016544:Patient Simulation; D010372:Pediatrics / Q000193:education* / Q000592:standards; D018743:Perinatal Care / Q000458:organization & administration* / Q000592:standards; D011247:Pregnancy; D011368:Professional-Family Relations; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D014743:Videotape Recording; D000078329:Workforce