title: Simulation based training in a publicly funded home birth programme in Australia: A qualitative study.
abstract: BACKGROUND
  Birth at home is a safe and appropriate choice for healthy women with a low risk pregnancy. However there is a small risk of emergencies requiring immediate, skilled management to optimise maternal and neonatal outcomes. We developed and implemented a simulation workshop designed to run in a home based setting to assist with emergency training for midwives and paramedical staff. The workshop was evaluated by assessing participants' satisfaction and response to key learning issues.
  
  
  METHODS
  Midwifery and emergency paramedical staff attending home births participated in a simulation workshop where they were required to manage birth emergencies in real time with limited availability of resources to suit the setting. They completed a pre-test and post-test evaluation form exploring the content and utility of the workshops. Content analysis was performed on qualitative data regarding the most important learning from the simulation activity.
  
  
  RESULTS
  A total of 73 participants attended the workshop (midwifery=46, and paramedical=27). There were 110 comments, made by 49 participants. The most frequently identified key learning elements were related to communication (among midwives, paramedical and hospital staff and with the woman's partner), followed by recognising the role of other health care professionals, developing an understanding of the process and the importance of planning ahead.
  
  
  CONCLUSIONS
  Home birth simulation workshop was found to be a useful tool by staff that provide care to women who are having a planned home birth. Developing clear communication and teamwork were found to be the key learning principles guiding their practice.
authors: Monash Women's Maternity Services, Monash Health, Victoria, Australia; The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia. Electronic address: arunaz.kumar@monash.edu.
authors: Arunaz
authors: A
authors: Kumar
authors: School of Rural Health, HealthPEER, Monash University, Victoria, Australia.
authors: Debra
authors: D
authors: Nestel
authors: Monash Women's Maternity Services, Monash Health, Victoria, Australia.
authors: Sally
authors: S
authors: Stoyles
authors: Monash Women's Maternity Services, Monash Health, Victoria, Australia; School of Nursing and Midwifery, Monash University, Victoria, Australia.
authors: Christine
authors: C
authors: East
authors: Monash Women's Maternity Services, Monash Health, Victoria, Australia; The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia.
authors: Euan M
authors: EM
authors: Wallace
authors: Monash Women's Maternity Services, Monash Health, Victoria, Australia.
authors: Colleen
authors: C
authors: White
mesh_terms: D001315:Australia; D004632:Emergency Medical Services; D005260:Female; D006282:Health Personnel / Q000193:education*; D006700:Home Childbirth / Q000191:economics / Q000193:education*; D006801:Humans; D008880:Midwifery / Q000193:education*; D009721:Nurse Midwives / Q000193:education*; D036801:Parturition; D016544:Patient Simulation; D011247:Pregnancy; D015397:Program Evaluation; D036301:Qualitative Research
keywords: Emergency; Interprofessional; Midwifery; Obstetric; Paramedical