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(Research Abstract Professor Rounds: Group 1) Emergencies in Clinical Obstetrics (ECO) Course and Competency-Based Assessment Used in Preparing Wake Forest Baptist Medical Center Nurses for Expanded Labor and Delivery Service (1090-003822)
Start time: Tuesday, January 26, 2021, 2:00 PM End time: Tuesday, January 26, 2021, 3:00 PM Session Type: Research Abstracts (Completed Studies) Cost: $0.00
Content Category: Researcher
Hypothesis:
The Center for Experiential and Applied Learning partnered with The American College of Obstetricians and Gynecologists (ACOG) to identify a relevant adoptable curriculum. The Emergencies in Clinical Obstetrics (ECO) course was used to train nurses in management of obstetrical emergencies. Pre-learn video modules were sent to participants. The ACOG ECO training, led by skilled and certified facilitators, included lectures on shoulder dystocia, breech birth, umbilical cord prolapse, and postpartum hemorrhage. Teamwork and communication strategies (TeamSTEPPS™) were reviewed (2). Simulation exercises, reinforcing skills through referencing checklists and role-play were performed using high fidelity and task trainer birthing simulators. Pre/post competency-based assessments were administered to evaluate understanding of material/simulations and gauge proficiencies in dealing with emergencies presented during and after childbirth. Post-training evaluations collected learner feedback.
Methods:
The Center for Experiential and Applied Learning partnered with The American College of Obstetricians and Gynecologists (ACOG) to identify a relevant adoptable curriculum. The Emergencies in Clinical Obstetrics (ECO) course was used to train nurses in management of obstetrical emergencies. Pre-learn video modules were sent to participants. The ACOG ECO training, led by skilled and certified facilitators, included lectures on shoulder dystocia, breech birth, umbilical cord prolapse, and postpartum hemorrhage. Teamwork and communication strategies (TeamSTEPPS™) were reviewed (2). Simulation exercises, reinforcing skills through referencing checklists and role-play were performed using high fidelity and task trainer birthing simulators. Pre/post competency-based assessments were administered to evaluate understanding of material/simulations and gauge proficiencies in dealing with emergencies presented during and after childbirth. Post-training evaluations collected learner feedback.
Results:
A paired t-test compared pre-post competency results. There was a statistically significant (p <0.05) improvement in competence following the simulation training (pre-test = 77.3 + 1.5; post-test = 89.0 + 0.8; n=58). Class participants were asked to complete a survey evaluating their before and after knowledge of protocols, techniques, risk factors, and team collaboration. On a scale of 1 (not at all confident) to 4 (very confident), the mean self-ranked score among nurses was 2.3 before the intervention and 3.5 afterward. When asked to evaluate the class in terms of course material, simulation experience, and facilitator's ability to effectively teach, participants rated the class 3.9 on a scale of 1 (strongly disagree) to 4 (strongly agree). When asked to name the ONE thing they learned in the class that they planned to apply in the clinical setting or share with colleagues, 57% of responses were related to technique and protocol, while 43% were about communication and teamwork.
Conclusions:
Nurses at Wake Forest Baptist Medical Center demonstrated day one readiness to open the new Birth Center through reaching competency-based assessment thresholds (>80%) and improved post-test scores following simulation training paired with didactic learning. Program improvements have been implemented regularly as the result of participant feedback surveys, test scores, and facilitators’ observation of gaps in competence or technique. For example, maternal cardiac arrest training has been added to the course to address the rise in maternal mortality in the United States (3). ACOG ECO training has expanded from military hospitals into civilian institutions, and was designed to be trained among multidisciplinary audiences to better care for patients. Monthly simulation training now occurs in the Birth Center at Wake Forest to regularly reinforce best practices during obstetric emergencies.