Simulation-based team training for multi-professional obstetric care teams to improve patient outcome: a multicentre, cluster randomised controlled trial

A. F. Fransen*, J. van de Ven, E. Schuit, A. A. C. van Tetering, B. W. Mol, S. G. Oei

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

44 Citations (Web of Science)

Abstract

Objective To investigate whether simulation-based obstetric team training in a simulation centre improves patient outcome.

Design Multicentre, open, cluster randomised controlled trial.

Setting Obstetric units in the Netherlands.

Population Women with a singleton pregnancy beyond 24 weeks of gestation.

Methods Random allocation of obstetric units to a 1-day, multiprofessional, simulation-based team training focusing on crew resource management (CRM) in a simulation centre or to no such team training. Intention-to-treat analyses were performed at the cluster level, including a measurement 1 year prior to the intervention.

Main outcome measures Primary outcome was a composite outcome of obstetric complications during the first year postintervention, including low Apgar score, severe postpartum haemorrhage, trauma due to shoulder dystocia, eclampsia and hypoxic-ischaemic encephalopathy. Maternal and perinatal mortality were also registered.

Results Each study group included 12 units with a median unit size of 1224 women, combining for a total of 28 657 women. In total, 471 medical professionals received the training course. The composite outcome of obstetric complications did not differ between study groups [odds ratio (OR) 1.0, 95% confidence interval (CI) 0.80-1.3]. Teamtraining reduced trauma due to shoulder dystocia (OR 0.50, 95% CI 0.25-0.99) and increased invasive treatment for severe postpartumhaemorrhage (OR 2.2, 95% CI 1.2-3.9) compared with no intervention. Other outcomes did not differ between study groups.

Conclusion A 1-day, off-site, simulation-based team training, focusing on teamwork skills, did not reduce a composite of obstetric complications.

Original languageEnglish
Pages (from-to)641-650
Number of pages10
JournalBjog-an International Journal of Obstetrics and Gynaecology
Volume124
Issue number4
DOIs
Publication statusPublished - Mar 2017

Keywords

  • Multi-professional training
  • obstetric care
  • patient outcome
  • simulation
  • team training
  • teamwork skills
  • SHOULDER DYSTOCIA
  • RESOURCE-MANAGEMENT
  • DELIBERATE PRACTICE
  • MEDICAL-EDUCATION
  • ADVERSE OUTCOMES
  • EMERGENCIES
  • SKILLS
  • DELIVERY
  • SERIES
  • IMPLEMENTATION

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