Simulation‐based obstetric team training to improve the over | Figure 1
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Simulation‐based obstetric team training to improve the overall outcome of obstetric health care
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To determine the effect of simulation‐based obstetric team training on patient outcomes, performance of the obstetric care team in practice and educational settings, and trainees' experience, when compared to no training or another type of training.
What is the issue?
Obstetric emergencies are pregnancy‐related conditions that can threaten the well‐being of mother and baby in pregnancy or around birth. These emergencies can happen at any time, result in high‐level pressure with high‐stakes decisions, and technical and ethical challenges of caring for both the mother and her child. Organisational and human factors are considered to be major sources of preventable, substandard care. Simulation‐based team training focuses on building a system that will anticipate errors, improve patient outcomes and the performance of obstetric care teams.
Why is this important?
Adequate performance of the obstetric care team is essential for safe management of obstetric emergencies. Inadequate performance of care teams can lead to substandard care resulting in poor outcomes for mothers and their children. Simulation‐based obstetric team training has been recommended to improve the overall outcome and quality of obstetric health care. Its effectiveness needs to be evaluated.
What evidence did we find?
The search was performed in April 2020. We identified eight randomised studies. Six cluster‐randomised studies compared simulation‐based obstetric team training with no training.
Kirkpatrick level 4 (patient outcome): simulation‐based obstetric team training may make little or no difference for a combination of adverse events in the mother or the infant. We are uncertain whether simulation‐based obstetric team training affects the risk of death for the mother. However, it may reduce the risk of death for the newborn baby. Simulation‐based obstetric team training may have little to no effect on low Apgar score but it probably reduces trauma after shoulder dystocia and probably slightly reduces the number of caesarean deliveries.
Kirkpatrick level 3 (performance in practice): we found that simulation‐based obstetric team training probably improves the performance of the obstetric teams in practice.
What does this mean?
Simulation‐based obstetric team training might be helpful for the improvement of team performance and specific maternal and perinatal outcomes. High‐certainty evidence was lacking due to limitations in the way the studies were designed and conducted. Six studies were performed in high‐income countries (the Netherlands, the UK, and the USA), and two studies were performed in a middle‐income country (Mexico).This meant that we could not combine all the data to reach robust conclusions. Future studies investigating simulation‐based obstetric team training compared to different designs of training courses should carefully consider how and when to measure the effects of the interventions.
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