Obstetric skills drills: Evaluation of teaching methods

• Published in: Nurse education today Vol. 27; no. 8; pp. 915 - 922
• Main Authors: Birch, L., Jones, N., Doyle, P.M., Green, P., McLaughlin, A., Champney, C., Williams, D., Gibbon, K., Taylor, K.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.11.2007; Elsevier Science Ltd
• Subjects: Anxiety; Attitude of Health Personnel; Childbirth; Clinical Competence; Clinical training; Communication; Communication skills; Education, Nursing, Continuing - methods; Education, Nursing, Continuing - standards; Emergencies; Emergencies - nursing; Emergency services; Emergency training; Health care management; Hemorrhage; High risk; Hospitals, District; Hospitals, General; Humans; Interdisciplinary aspects; Interprofessional Relations; Interviews; Midwifery; Nursing education; Nursing Education Research; Nursing Methodology Research; Nursing Staff, Hospital - education; Nursing Staff, Hospital - psychology; Obstetric Nursing - education; Obstetrics; Patient Care Team; Postpartum haemorrhage; Postpartum Hemorrhage - nursing; Postpartum period; Postpartum women; Problem-Based Learning - methods; Problem-Based Learning - standards; Program Evaluation; Qualitative Research; Research subjects; Retention (Psychology); Risk Management; Self Efficacy; Semi Structured Interviews; Simulation; Simulation based training; Skill development; Skills drills; Statistical significance; Surveys and Questionnaires; Teaching - methods; Teaching - standards; Teams; Teamwork; Training; United Kingdom; United Kingdom > UK; Postpartum haemorrhage; Skills drills; Simulation based training; Teaching methods; Teamwork; Emergency training
• ISSN: 0260-6917; 1532-2793
• DOI: 10.1016/j.nedt.2007.01.006

To determine the most effective method of delivering training to staff on the management of an obstetric emergency. The research was conducted in a District General Hospital in the UK, delivering approximately 3500 women per year. Thirty-six staff, comprising of junior and senior medical and midwifery staff were included as research subjects. Each of the staff members were put into one of six multi-professional teams. Effectively, this gave six teams, each comprising of six members. Three teaching methods were employed. Lecture based teaching (LBT), simulation based teaching (SBT) or a combination of these two (LAS). Each team of staff were randomly allocated to undertake a full day of training in the management of Post Partum Haemorrhage utilising one of these three teaching methods. Team knowledge and performance were assessed pre-training, post training and at three months later. In addition to this assessment of knowledge and performance, qualitative semi-structured interviews were carried out with 50% of the original cohort one year after the training, to explore anxiety, confidence, communication, knowledge retention, enjoyment and transferable skills. All teams improved in their performance and knowledge. The teams taught using simulation only (SBT) were the only group to demonstrate sustained improvement in clinical management of the case, confidence, communication skills and knowledge. However, the study did not have enough power to reach statistical significance. The SBT group reported transferable skills and less anxiety in subsequent emergencies. SBT and LAS reported improved multidisciplinary communication. Although tiring, the SBT was enjoyed the most. Obstetrics is a high risk speciality, in which emergencies are to some extent, inevitable. Training staff to manage these emergencies is a fundamental principal of risk management. Traditional risk management strategies based on incident reporting and event analysis are reactive and not always effective. Simulation based training is an appropriate proactive approach to reducing errors and risk in obstetrics, improving teamwork and communication, whilst giving the student a multiplicity of transferable skills to improve their performance.