Artículo de revisión

Published on 3 de noviembre de 2023 | http://doi.org/10.5867/medwave.2023.10.2712

Clinical simulation training for the adequate management of obstetrics emergencies: A narrative review

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Characteristics overview of the included studies.
First author (Year)CountryStudy designObjectivesParticipantsSimulation application(s)InterventionValidation/EvaluationMain outcomes
Walker et al. (2014) [3]MexicoRCTEvaluate the impact of PRONTO on knowledge, self-efficacy, and teamwork.HP (obstetrics and neonatology)(n = 450) from 24 hospitalsHigh realism/low technology and cost simulation (NeoNatalie® manikin, PartoPants™)IG: SBT (SOON)CG: no training (n = 12)Pre-test and post-testKnowledge (+)Self-efficacy (+)Teamwork (+)
Monod et al. (2013) [7]SwitzerlandOSTo investigate the influence of SBT on four specific skills: self-confidence, management of emergencies, knowledge of algorithms, and team communication.Midwives and obstetricians(n = 168)HF simulation Noelle® (Gaumard, Miami, FL, USA) Ambu® Man (Ambu, Ballerup, Denmark) SimMan® Classic and 3G (Laerdal Medical, Stavanger, Norway)Clinical course and training on the mannequinPost-testSelf-confidence (+)Ability to handle emergencies (+)Knowledge (+)Team communication (-)
Michelet et al. (2019) [8]FranceRCTAssessing the impact of midwifery SBT on NTC through a PPH virtual simulationMidwives (n = 24)Virtual simulation on PerinatSims screenIG: scenarios with CNT trainingCG: scenarios without CNT trainingPost-testPerformance (+) in IG
Yu et al. 2020) [10]South KoreaDSConfirming the effectiveness of interprofessional education by comparing students' attitudes toward interprofessional learning before and after SBTMedical and nursing students (n = 75)RP mannequins

Pre-briefing

Pre-staging activities

Task training

Simulation

- Debriefing

Pre-test and post-testAwareness (+)Self-competence (+)
Sami et al. (2019)[21]Saudi ArabiaQES(without CG)To evaluate the effectiveness of a SBT program on nurses' knowledge and confidence in managing obstetric emergencies and retention of acquired competencies.Nurses and midwives(n = 30)AF Noel birth simulator in a simulated labor and delivery patient room.

Pre-briefing

Simulation

Debriefing

Post-testKnowledge acquisition and retention (+)Confidence (+)
Osman et al. (2021)[22]EgyptQES(without CG)Evaluating the effect of HF simulation on nursing students' knowledge of obstetric emergencies, confidence, and satisfactionNursing students(n = 30)HF mannequin and other medical equipment

Pre-briefing

Simulation

Debriefing

Pre-test and post-testKnowledge (+)Confidence (+)Satisfaction (+)
Pansuwan et al. (2012)[23]ThailandQES(without CG)Examining the effect of SBT on performance in nursing care in early PPHNursing students(n = 30)SimMom

Prebriefing

Role-playing

Debriefing

Reflective feedback

Pre-test and post-testPerformance (+)
Andrighetti et al. (2012)[24]United StatesQES(with CG)To determine whether the use of HF simulation for the obstetric emergencies of SD and PPH increases students' confidence in managing these complicationsMidwifery students(n = 28)SPStatic mannequinIG: SBTCG: class discussion and videoPre-test and post-testConfidence (+), in the IG
Kato et al. (2017) [25]JapanRCTExploring the effectiveness of SBT for midwives on performance and knowledge for the management of PPHMidwives(n = 81)Mannequins with patient-actorsGI: prior e-learning and SBT (n = 40)CG: no training (n = 41)Pre-test and post-testPerformance (+)Knowledge (+), in the IG
Ellis et al. (2008) [26]United KingdomRCTTo compare the effectiveness of eclampsia training in local hospitals and a regional simulation center, with and without teamwork theory.Midwives and obstetricians (n = 140).Advanced Human Patient Simulator (SimMan; Laerdal Medical Corporation, Orpington, Kent, UK)Standardized video-recorded eclampsia scenarioIG: with teamwork theoryCG: without teamwork theoryPre-test and post-testRendimiento (+)Teoría del trabajo en equipo (-)
Daniels et al. (2010) [27]United StatesRCTTo determine whether SBT was more effective than conventional didactic teaching in training delivery teams on crisis management.Nurse and obstetric residents (< 5 years of experience), (n = 32)Programmable fetal monitorPelvic model Simulated patient mannequinVideo recording systemIG: SBTCG: lectures/video and hands-on demonstrationPre-test and post-testPerformance (+), in the IG
Kordi et al.(2017)[28]IranQES(with CG)To compare the impact of SBT and oral technique on midwifery skills in the management of SDMidwives(n = 51)SP molded with a fetusIG: FBSCG: readingPre-test and post-testPerformance (+), in the IG
Fransen et al. (2015) [29]NetherlandsRCTTo investigate whether obstetric team SBT in a simulation center improves patient outcomes.Interdisciplinary obstetrical teams (n = 471)HF simulators [Noelle TM (Gaumard Miami, FL, USA) and Emergency Care Simulator ECSTM ( Medical Education Technologies, Inc., Sarasota, FL, USA)].IG: SBT on obstetrics equipmentCG: no training or traditional trainingPre-test and post-testPerformance (+)Reduction of SD trauma (+)PPH management (+), in IG
Fisher et al. (2011) [30]United StatesQES(without CG)To determine the impact of maternal cardiac arrest SBT on maternal-fetal healthcare professionals' performance, knowledge, and confidence.Maternal-fetal healthcare professionals (n=19)HF Simulator (NOELLE®; Guamard Scientific, Coral Gables, FL)Basic life support course, lecture on modification of advanced CPR in pregnancy, and simulation practicePost-testPerformance (+)Knowledge (+)Confidence (+)
Lipman et al. (2010) [31]United StatesOSTo assess the quality of obstetric CPR performed during the management of simulated cardiac arrest in a pregnant patient at term.Labor and delivery nurses, anesthesiology residents, obstetrics residents, or attending physicians (n = 69).Fetal Monitors (FetalSim Advanced Medical Simulations, Inc., Binghamton, NY)Pelvic model (Simulaids Inc, Saugerties, NY)patient simulator (SimMan; Laerdal Medical, Wappinger Falls, NY)Videotaped simulated scenariosPost-testCPR Practice Performance (-)
Siassakos et al. (2009) [32]United KingdomOSTo determine whether the introduction of interdisciplinary SBT was associated with improvements in the management of cord prolapse, in particular, the diagnostic-delivery intervalMaternity HP(n = not specified)Patient-actor.Cushion to mimic a pregnant woman’s abdomen.Model of a baby with its umbilical cord.Simulated perineum.Application of simulated umbilical cord prolapse management protocolPre-test and post-testPerformance (+)
Vellanki el al. (2010) [33]IndiaQES(with CG)To determine the effectiveness of cesarean section training with obstetric simulators for medical students during their internship.Medical students (n = 25)MF or HF surgical simulatorIG: SBT supervised by a teacherCG: no trainingPost-testConocimientos (+) Habilidades (+) Satisfacción (+)en GI
Gum et al. (2010) [34]AustraliaQSTo determine how interprofessional SBT improved maternity emergency care and team performance.Maternity HP(n = 17)Human Simulation

Clinical Simulation Workshops

Videotaped Simulation

Debriefing

Post-testTeam performance (+)
Hernández et al. (2021) [35]SpainQES(without CG)To analyze the impact and evaluate the effects of HF SBT on obstetric emergencies in an interdisciplinary group.Gynecologists, midwives, and auxiliary nurses(n = 30)Lucina® by computer-assisted engineering Fidelis

Case selection

Simulation

Assessment

Pre-test and post-testSkills (+)Satisfaction (+)
Edwards et al. (2015) [36]United KingdomOSTo assess interprofessional attitudes and clinical knowledge.Medical and midwifery students (n=72)HF and LF simulators (SimMom, PROMPT, Birthing Simulator, MamaNatalie, ResusciAnne, and patient actors)Lectures, teamwork exercises, and SBT for SD, sepsis, hemorrhage, collapsePost-testInterprofessional attitudes in all areas (+)Knowledge (+)

HF: high fidelity; LF: low fidelity; NTS: non-technical skills; SD: shoulder dystocia; QS: qualitative study; RCT: randomized clinical trial; QES: quasi-experimental study; SBT: simulation-based training; MF: medium fidelity; DS: descriptive study; OS: observational study; RP: role play; CG: control group; IG: intervention group; PPH: postpartum hemorrhage; CPR: cardiopulmonary resuscitation; HP: healthcare professionals; PRONTO: obstetric and neonatal rescue program: optimal and timely treatment; SP: standardized patient; (+): confirmed relevance; (-): not relevant.

A summary of research that examined the efficacy of simulation training in obstetric emergencies among several countries.

Source: Prepared by the authors.