Obstetric Emergency Drill: Does it Change our Knowledge and Skill?

Rosina Manandhar; Rachana Saha; Dipty Shrestha; Rumina Malla

Rosina Manandhar Department of Obstetrics and Gynaecology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Rachana Saha Department of Obstetrics and Gynaecology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Dipty Shrestha Department of Obstetrics and Gynaecology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Rumina Malla dDepartment of Obstetrics and Gynaecology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.

Abstract

Introduction: Obstetric emergencies are unpredictable and inappropriate management of such events can result in serious maternal and neonatal morbidity and mortality. Simulation and drill provides obstetric emergency training in a safe environment with an aim of improving clinical outcome. The aim of this study was to evaluate the impact of obstetric emergency training on the change in the knowledge, clinical skill and teamwork performance of the participants in the management of common obstetric emergencies: eclampsia, shoulder dystocia and post-partum haemorrhage.

Methods: A hospital based interventional study was conducted amongst 11 residents, 4 medical officers and 45 interns. Pre-training and post-training assessment of the knowledge by using Multiple choice questions (MCQs), clinical skills by using Objective Structured Clinical Examination (OSCE) and teamwork performance by using Mayo High Performance Teamwork Scale (MHPTS) was undertaken in each of the modules: Eclampsia, Shoulder dystocia and Post-partum haemorrhage. Training intervention was undertaken by using standardized lectures and simulated clinical emergency scenarios. The changes in MCQs, OSCE and MHPTS scores were analyzed.

Results: There was a significant improvement in the mean MCQ score (p-value ˂0.001) and OSCE score (p-value ˂0.001), overall and individually, in each module. After the training, a greater number of participants could perform the clinical skill components. There was also a significant improvement in post training MHPTS score (p-value˂0.001). Conclusions: Obstetric emergency drill and training significantly increased the knowledge, clinical skills and teamwork performance of participants in the management of important obstetric emergencies.

Keywords: eclampsia; obstetric emergency; post-partum haemorrhage; shoulder dystocia; simulation.