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      Modified Advanced Life Support in Obstetrics course: Feasibility, trainee satisfaction, and sustainability potential

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          Abstract

          Objective: The main objective of this initiative was to present evaluation results from an innovative adaptation of the Advanced Life Support in Obstetrics (ALSO) training course. We modified the traditional ALSO curriculum in our institution by adding hands-on training in laceration repairs and simulation scenarios on acute maternity care.

          Methods: The modified ALSO provider course was designed to enhance cognitive and procedural skills of health care professionals in managing obstetric emergencies. Forty-nine participants attended this course and completed a posttraining survey. Descriptive statistics were used to describe the participant-reported assessment scores for the ALSO course on three domains (subject knowledge, organization and clarity, and teaching effectiveness) for each of 12 course topics.

          Results: Evaluation of the results showed a high rate of trainee satisfaction as evidenced by the mean assessment scores across all topics ranging from 4.80 to 4.98 (out of 5.00). All trainees said they would refer others to the course. Our modified ALSO course effectively addressed the important needs of primary care physicians involved in maternity care, especially in underserved communities where specialized obstetric care is not readily available. Both simulation scenarios and workshops using simulated human tissue provide a better foundation before formal training.

          Conclusion: Given the changing legal and regulatory climate, we expect that learning to treat complex obstetric situations on the job will become increasingly risky. With this in mind, both simulation scenarios and workshops using simulated human tissue will provide a better foundation before formal training.

          Most cited references9

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          Self-perceived impact of simulation-based training on the management of real-life obstetrical emergencies.

          To evaluate the self-perceived impact of attending a simulation-based training course on the management of real-life obstetrical emergencies. A prospective follow-up study was conducted. Obstetric nurses and obstetricians (n=54) from a tertiary care university hospital participated in a simulation-based training course for the management of four obstetric emergencies. One year after the last session of the course, participants were asked to complete a questionnaire evaluating the self-perceived impact it had on their knowledge, technical skills, and teamwork skills during experienced real-life situations. A five-point Likert grading scale was used. The χ(2) test with one degree of freedom or the Fisher's exact test were used to compare groups of participants. The t-test for independent samples was used to compare mean scores between groups. A total of 46 healthcare professionals answered the questionnaire: 27 obstetricians and 19 obstetric nurses. Of these, 87% perceived an improvement (scores 4 or 5) in their knowledge and skills during real emergencies. Obstetric nurses expressed a significantly higher improvement than obstetricians in their ability to diagnose or be aware of obstetrical emergencies (p=0.002), in their technical skills (p=0.024), and in their ability to deal with teamwork related issues (p=0.005). Participants who had experienced in real-life situations all four simulated scenarios rated the impact of training significantly higher than others (p=0.049), and also reported a better improvement in their knowledge of management guidelines (p=0.006). Healthcare professionals who participated in a simulation-based training course in obstetrical emergencies perceived a substantial improvement in their knowledge and skills when witnessing real-life emergencies. Improvements seem to be particularly relevant for obstetric nurses and for those who witness all trained obstetrical emergencies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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            The use of simulation to teach clinical skills in obstetrics.

            Obstetrical practice demands sensitivity, clinical skill, and acumen. Obstetrical emergencies are rare occurrences and are most appropriately dealt with by experienced staff. Simulation provides an opportunity to gain this experience without patient risk and furthermore builds confidence and satisfaction amongst learners. There is an abundance of evidence to show the effectiveness of simulation training. Simulation has been demonstrated to reduce errors, increase knowledge, skills, communication and team working, and improve perinatal outcomes. Further research to measure the effect of training to identify what works, where and at what cost is needed. We explore the evidence for the use of simulation-based training across a broad range of obstetrical emergencies, promote collaboration amongst disciplines and discuss the formal introduction of simulation training into a curriculum. Reducing preventable harm in obstetrics is a priority for families and society at large and this article endeavors to highlight the role that simulation has to play. Copyright © 2011 Elsevier Inc. All rights reserved.
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              Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an Advanced Life Support in Obstetrics course in Australia.

              The Advanced Life Support in Obstetrics (ALSO) course is an internationally recognised interprofessional course to support health professionals to develop and maintain the knowledge and skills to manage obstetric emergencies.
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                Author and article information

                Journal
                FMCH
                Family Medicine and Community Health
                FMCH
                Compuscript (Ireland )
                2009-8774
                2305-6983
                May 2017
                May 2017
                : 5
                : 1
                : 71-77
                Affiliations
                [1] 1Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
                [2] 2College of Public Health, University of South Florida, Tampa, FL, USA
                Author notes
                CORRESPONDING AUTHOR: Anjali Aggarwal, MD, Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Houston, TX 77098, USA, E-mail: aaggarwa@ 123456bcm.edu
                Article
                FMCH.2017.0107
                10.15212/FMCH.2017.0107
                04e2fc09-8a72-4a31-bb31-754ec83641ce
                Copyright © 2017 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 1 December 2016
                : 2 March 2017
                Categories
                Original Research

                General medicine,Medicine,Geriatric medicine,Occupational & Environmental medicine,Internal medicine,Health & Social care
                simulated human tissue,Advanced Life Support in Obstetrics (ALSO),training,hands-on laceration repair

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