Kumar Arunaz, Sturrock Sam, Wallace Euan M, Nestel Debra, Lucey Donna, Stoyles Sally, Morgan Jenny, Neil Peter, Schlipalius Michelle, Dekoninck Philip
Monash Women's Service, Monash Health, Melbourne, Australia.
Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
BMJ Open. 2018 Feb 17;8(2):e017451. doi: 10.1136/bmjopen-2017-017451.
The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice.
Mixed methods approach with a pre-test/post-test design.
Healthcare network providing obstetric care in Victoria, Australia.
Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011-2012 (n=15 361 births) and 2014-2015 (n=12 388 births).
Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills.
Clinical outcomes compared before and after embedding PROMPT in educational practice.
Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice.
There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies.
Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.
本研究旨在使用柯克帕特里克框架评估实用产科多专业培训（PROMPT）模拟的实施情况。我们探讨了参与者知识和技能的获取情况、其对临床结果和组织变革的影响，以将PROMPT计划整合为一种资质认证工具。我们还旨在评估参与者对PROMPT在其临床实践中有用性的看法。
采用前测/后测设计的混合方法。
澳大利亚维多利亚州提供产科护理的医疗网络。
2013年至2015年间参加PROMPT的医护人员（n = 508）；在两个队列中评估临床结果：2011 - 2012年（n = 15361例分娩）和2014 - 2015年（n = 12388例分娩）。
参加PROMPT计划，这是一个在多学科团队中开展的模拟计划，以促进产科急救技能的教学。
在教育实践中引入PROMPT前后比较临床结果。
通过定性分析评估参与者获得的知识，并描述将PROMPT引入教育实践的过程。
通过早期识别和干预，产后出血的管理发生了变化。参与者描述的关键学习主题包括事先了解程序和设备、沟通、领导能力以及在安全、支持性环境中的学习。参与者报告称，通过PROMPT计划有积极的学习体验，并且在处理产科紧急情况时信心增强，该计划被视为对紧急情况的真实演示。
参与者报告临床和非技术技能均有所提高，突出了团队合作、沟通、领导能力以及紧急情况下优先级排序的原则。产后出血的管理有所改善，但在引入PROMPT后的两年期间临床结果未观察到显著变化。然而，医护人员获得的技能证明将PROMPT纳入教育计划是合理的。
