The improvement and retention of skills in shoulder dystocia management with the use of high-fidelity simulation: The SAFE (SimulAtion high-FidElity) study.

Autor: Papoutsis D; Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani 50200, Greece; Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Apley Castle, Grainger Drive, Telford TF16TF, United Kingdom. Electronic address: dpapoutsis@uowm.gr., Klazoglou P; Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani 50200, Greece., Valasoulis G; Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani 50200, Greece; Department of Obstetrics and Gynaecology, Medical School, University of Thessaly, Larissa 41500, Greece., Tzavara C; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece.
Jazyk: angličtina
Zdroj: Women and birth : journal of the Australian College of Midwives [Women Birth] 2024 May; Vol. 37 (3), pp. 101590. Date of Electronic Publication: 2024 Feb 16.
DOI: 10.1016/j.wombi.2024.02.006
Abstrakt: Background: Shoulder dystocia is a relatively uncommon but serious childbirth-related emergency.
Aim: To explore the improvement and retention of skills in shoulder dystocia management through high-fidelity simulation training.
Methods: The SAFE (SimulAtion high-FidElity) study was a prospective cohort study that utilised a high-fidelity birth simulator. Registered midwives and final year midwifery students were invited to participate in a one-day workshop at 6-monthly intervals. There was a 30-minute initial assessment, a 30-minute theoretical and hands-on training, and a 30-minute post-training assessment on shoulder dystocia management. Pre-training and post-training values for the predetermined outcomes were compared. In each workshop we assessed the proportion of successful simulated births, the performance of manoeuvres to manage shoulder dystocia, the head-to-body birth time, the fetal head traction force, the quality of communication, the perception of time-to-birth, and the self-reported confidence levels.
Findings: The baseline workshop recruited 101 participants that demonstrated a significant increase in the proportion of successful simulated births (8.9% vs 93.1%), and a two-fold to three-fold increase in the score of manoeuvres, communication, and confidence after training. Those with low pre-training levels of competency and confidence improved the most post-training at baseline. There was a retention of manoeuvres, communication skills and confidence at 6 months. There was no reduction in fetal head traction force over time. Those being proficient before initial training retained and performed best at the 6-month follow-up.
Conclusion: The SAFE study found a significant improvement in skills and confidence after the initial high-fidelity simulation training that were retained after 6 months.
(Copyright © 2024 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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