Simulation training program for midwives to manage postpartum hemorrhage: A randomized controlled trial.
OBJECTIVE
To explore the effectiveness of a simulation training program for midwives in performance and knowledge for the management of postpartum hemorrhage (PPH).


METHODS
The study design was a randomized controlled trial. Midwives working at one obstetrics ward in an urban area were randomly assigned to simulation training program or no training. This "simulation program" included pre study e-learning and simulation. Inclusion criteria were midwives who: 1) had two or three years of clinical experience, 2) worked in an obstetrics ward, and 3) had experience with birth assistance. There was one exclusion criterion namely prior experience of simulation training for PPH. Change in performance was evaluated using a PPH scenario performance test at one month after the simulation training. Change in knowledge was evaluated by a 25-item multiple-choice questionnaire completed shortly before the training and one month after the training. The ethical review committee of St Luke's International University granted approval (No. 14-096).


RESULTS
Eighty-one midwives were randomly assigned to either the intervention group (n=40) or the control group (n=41). Performance in the simulation training group was significantly better in comparison to the no training group; mean performance score was 23.85(SD 2.71) in the training group versus 18.00(SD 3.01) in the no training group (MD 5.85 95% CI 4.85-7.12, t=9.17, p<0.001). Knowledge was significantly increased in the simulation training group; amount of knowledge score was 3.65(SD 3.40) in the training group versus -0.02(SD 3.02) in the no training group (MD 3.67 95% CI 2.25-5.10, t=5.14, p<0.001).


CONCLUSIONS
Both performance and knowledge about the management of PPH were significantly improved after simulation training. However, assessments of long-term effects on performance, and knowledge and the clinical outcomes in managing of obstetric complications are necessary to adequately evaluate the effectiveness of simulation training.
Nagasaki University School of Nursing Health Science, Division of Nursing, 1-7-1 Sakamoto Nagasaki-city, Nagasaki 852-8520, Japan. Electronic address: 13DN006-ts@slcn.ac.jp.
Chiho
C
Kato
St. Luke's International University, 3-8-5 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Electronic address: yaeko-kataoka@slcn.ac.jp.
Yaeko
Y
Kataoka
D000328:Adult; D002983:Clinical Competence; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008880:Midwifery / Q000193:education*; D009774:Obstetrics / Q000193:education*; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D000066908:Simulation Training / Q000379:methods*; D011795:Surveys and Questionnaires
Midwife; Obstetrics; Postpartum hemorrhage; Simulation