Effects of an instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study.
Objective: To compare postpartum hemorrhage (PPH) patient outcomes before and after an in situ instructional design based PPH simulation attended by obstetrics and gynecology (OBGYN) residents.Methods: This uncontrolled before-and-after study was conducted in Recife, Brazil including all 1388 women...
| Published in: | Journal of Maternal-Fetal & Neonatal Medicine Vol. 34; no. 2; pp. 245 - 253 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Taylor & Francis Ltd
Jan2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147176929&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147176929 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14767058 O6A jtl: Journal of Maternal-Fetal & Neonatal Medicine issn: 14767058 maglogo: Y pubinfo: dt: Jan2021 vid: 34 iid: 2 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 147176929 147176929 NLM31023119 147176929 10.1080/14767058.2019.1606195 NLM31023119 147176929 ppf: 245 ppct: 8 formats: tig: atl: Effects of an instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study. aug: au: de Melo, Brena Carvalho Pinto Van der Vleuten, Cees P. M. Muijtjens, Arno M. M. Rodrigues Falbo, Ana Katz, Leila Van Merriënboer, Jeroen J. G. affil: Centro de Atenção, à Mulher, Instituto de Medicina Integral Prof Fernando Figueira (IMIP), Recife, Brazil sug: subj: Gynecology Education Oxytocics Obstetrics Education Postpartum Hemorrhage Therapy Pregnancy Oxytocin Female Brazil Human Female ab: Objective: To compare postpartum hemorrhage (PPH) patient outcomes before and after an in situ instructional design based PPH simulation attended by obstetrics and gynecology (OBGYN) residents.Methods: This uncontrolled before-and-after study was conducted in Recife, Brazil including all 1388 women delivering from June to August 2012 and all 1357 delivering from June to August 2013. The 36 OBGYN residents were divided into13 teams of two or three participants and were trained through ID based PPH simulation training with the following eight steps: (1) prior knowledge activation, (2) video demonstration, (3) dual-coding PPH protocol discussion-an image association during the training, (4) training scenario # 1, (5) debriefing, (6) training scenario # 2 with immediate feedback, (7) training scenario # 3, and (8) debriefing with self-assessment. The training scenarios had an increasing level of complexity. The main goal of the training was the adequate management of PPH and situational awareness improvement-the ability to anticipate, recognize, and intercept unfolding error chains. The primary patient outcomes rates used for the before and after comparison were therapeutic uterotonics use within 24 h of birth and blood transfusion. Secondary outcomes were therapeutic oxytocin mean dosage IU within 24 h of birth, postpartum Hb < 6 g/dL, among others. Chi-square test was used for categorical variables comparison and independent t-test for continuous variables.Results: PPH rates were 100 (7.2% of 2012 deliveries) and 80 cases (5.9% of 2013 deliveries), respectively. Comparison of primary post- and pre-simulation outcomes revealed no significant differences. However, in the comparison for therapeutic oxytocin mean dosage IU within 24 h of birth, there was an increase found after the simulation (15.98 ± 7.4 versus 25.1 ± 12.3; p < .001). For all other outcome measures, there were no statistical differences.Conclusions:In situ ID based PPH simulation leads to an increase in the mean dosage of oxytocin after training, in selected cases. This may indicate better situational awareness when managing women with PPH. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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