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Introduction of Multi-Disciplinary Simulation Training in Obstetric Emergencies

Oral Presentation 5
Dr Saema Saeed, Dr Victoria Meighan, Dr Emer Kidney, Ms Sandra Hartigan

Introduction of Multi-Disciplinary Simulation Training in Obstetric Emergencies

Background:
Obstetric emergencies are very stressful for emergency physicians working in non obstetric hospitals. Obstetric emergencies require high quality time critical care from a multi disciplinary team. Following major incident debriefing after an obstetric emergency presentation, it was discovered our team felt stressed by these presentations because of lack of familiarity and training in obstetric emergencies.

Aims:
The aim of our simulation training was introduce a blended learning training session including multidisciplinary simulation based medical education to reduce health care provider fear and stress and to improve confidence in dealing with obstetric emergencies.

Method:
We designed a blended learning obstetric emergencies training day for a multidisciplinary team (MDT) which included the National Ambulance Service (Prehospital), Emergency Medicine medical and nursing staff, hospital porters, health care assistants, Obstetric and Gynaecology medical and nursing colleagues, Paediatric medical and nursing colleagues and Intensive care doctors. The simulations were focused on Eclampsia and Cardiac arrest in pregnancy and included two MDT simulation based medical education training sessions.

The scenarios had specified learning outcomes including technical and non technical skills training.

Each participant was asked to complete a standardised questionnaire afterwards and provide feedback on the training day. The structured simulated scenarios lead participants through patient handover, assessment, investigation and management decisions, followed by a structured debrief. Clinical results, equipment and live monitoring are used to increase the fidelity of the simulation.

Results:
Data was presented on survey responses from the 25 attendees (n=25, with a 100% response rate). It was a first ever simulation based training day on obstetric emergencies for 68% attendees. The course improved candidates' confidence (88% positive response) in dealing with these emergencies with all scoring above 8 on a linear scale on having learnt new skills and improving their clinical knowledge (22% rating it 10). 88% recommended regular training days annually. 84% found the training day very applicable to practice with 100% recommending it to other colleagues. 21 attendees stated they were very likely to apply skills learned in practice. Qualitative feedback included: “Good broad interactive session on a subject we often do not see in our ED” and “Fantastic, clinically relevant course.”

Conclusions:
Simulation is an established mode of acute medical education, and has a demonstrable benefit when applied to emergency medicine training. MDT simulation based medical education reduces stress and fear related to dealing with obstetric emergencies particularly for multidisciplinary teams in non-obstetric hospitals.