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, multi-professional, 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 post-intervention, 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]. Team training reduced trauma due to shoulder dystocia (OR 0.50, 95% CI 0.25–0.99) and increased invasive treatment for severe postpartum haemorrhage (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. Tweetable abstract: 1-day, off-site, simulation-based team training did not reduce a composite of obstetric complications.
Original language | English |
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Pages (from-to) | 641-650 |
Number of pages | 10 |
Journal | BJOG : An International Journal of Obstetrics and Gynaecology |
Volume | 124 |
Issue number | 4 |
DOIs | |
Publication status | Published - 1 Mar 2017 |
Keywords
- Multi-professional training
- obstetric care
- patient outcome
- simulation
- team training
- teamwork skills
- Humans
- Emergencies
- Patient Care Team
- Pregnancy
- Netherlands
- Postpartum Hemorrhage
- Perinatal Mortality
- Female
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Perinatal Medicine
M.B. (Beatrijs) van der Hout-van der Jagt (Content manager) & Eugenie Delvaux (Content manager)
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