title: Training program for the management of two obstetric emergencies within a French perinatal care network.
abstract: OBJECTIVE
  To evaluate the effectiveness of an interdisciplinary team training program based on simulated scenarios and focusing on two obstetrical emergency situations: shoulder dystocia and complicated breech vaginal delivery (CBVD). These situations are rare, so there are few opportunities for real-life training, yet their competent and efficient management is crucial to minimizing the risks to mother and child.
  
  
  METHODS
  The target population for training comprised the 450 professionals working in the French regional perinatal care network ELENA. An expert committee defined the topics for the training program, selected the simulated scenarios and developed the evaluation grids. The training sessions were conducted by two qualified and experienced professionals in each maternity unit. They comprised a theoretical introduction followed by practical exercises in management of simulated emergency situations by the participant teams, with the aid of a mannequin. Each team completed the exercises twice, their performances being filmed, reviewed and evaluated in each case.
  
  
  RESULTS
  The training sessions took place over 9 months between September 2012 and June 2013. A total of 298 professionals (obstetricians, residents in obstetrics, midwives and nursery nurses) were trained, representing 75% of the staff working in the ELENA perinatal care network. The results showed substantial and significant increases in the overall scores for management of the two emergency situations (from 74.5% to 91.4% for shoulder dystocia [p<0.0001], and from 67.2% to 88.4% [p<0.0001] for CBVD) as well as in the scores for all the specific areas of expertise assessed: safety, know-how, technique, team communication and communication with the patient.
  
  
  CONCLUSIONS
  This study demonstrated the value of multidisciplinary team training for obstetric emergencies, encouraging the ELENA perinatal care network to implement an annual training program for its staff. Over and above our experience, the future establishment of a national education program to optimize the management of obstetric emergencies seems to be essential.
authors.affiliation: Obstetrics and Gynecology Department, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France; Jean Monnet University, Faculty of Medicine, Saint Etienne, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Noblot
authors.affiliation: Obstetrics and Gynecology Department, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France; Jean Monnet University, Faculty of Medicine, Saint Etienne, France; EA 3065 Thrombosis Research Group, Jean Monnet University, Saint Etienne, France.
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Raia-Barjat
authors.affiliation: Antenatal Diagnosis Unit, Mother and Child Hospital, Bron, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Lajeunesse
authors.affiliation: Jean Monnet University, Faculty of Medicine, Saint Etienne, France; Public Health and Medical Information Department, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Trombert
authors.affiliation: ELENA Network Coordination, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Weiss
authors.affiliation: ELENA Network Coordination, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Colombié
authors.affiliation: Obstetrics and Gynecology Department, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France; Jean Monnet University, Faculty of Medicine, Saint Etienne, France; EA 3065 Thrombosis Research Group, Jean Monnet University, Saint Etienne, France. Electronic address: celine.chauleur@chu-st-etienne.fr.
authors.forename: Céline
authors.initials: C
authors.lastname: Chauleur
mesh_terms: D001946:Breech Presentation / Q000628:therapy*; D004420:Dystocia / Q000628:therapy*; D004493:Education / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D009774:Obstetrics / Q000193:education*; D010348:Patient Care Team; D011247:Pregnancy; D012782:Shoulder
keywords: Complicated breech vaginal delivery; Multidisciplinary team; Obstetric emergencies; Perinatal care network; Shoulder dystocia; Training