Yang Yike, Guo Zhichao, Guo Xiaoyue, Zhao Yangyu
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China.
J Obstet Gynaecol. 2025 Dec;45(1):2443617. doi: 10.1080/01443615.2024.2443617. Epub 2024 Dec 26.
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide, and effective training in PPH rescue techniques is crucial. This study aims to evaluate the effectiveness of combining case-based learning (CBL) and problem-based learning (PBL) with simulation teaching methods in improving midwifery trainees' technical proficiency in managing PPH.
This quasi-experimental study involved 76 trainees who received PPH training at Peking University Third Hospital from March to July 2023. They were divided into two groups: the control group ( = 50) followed traditional simulation training methods, and the research group ( = 26) used a combination of CBL-PBL and scenario simulation. After the training, all participants completed a theoretical examination and questionnaire to assess their satisfaction with the program and self-assessment of clinical management skills in PPH. Statistical analysis was performed using unpaired t-tests and chi-square tests to compare the groups.
The combination of CBL-PBL and scenario simulation was highly satisfactory compared to traditional simulation training, significantly enhancing self-assessed skills in clinical thinking (100% vs. 61.8%, = .03), operant skills related to PPH (100% vs. 57.4%, < .01), relevant knowledge pertaining to PPH (100% vs. 58.7%, < .01), and management abilities (97.1% vs. 39%, < .01) among midwifery trainees in the research group, who also scored significantly higher on post-training assessments of PPH knowledge than control groups(91.7 ± 6.0 vs 76.0 ± 7.1, < .01). A majority of trainees expressed a preference for regular simulation exercises (98.7%) and detailed discussions on PPH cases (93.4%) in future training sessions.
Combining CBL-PBL with simulation practice is a more effective teaching method for PPH management training in maternity staffs with a certain level of clinical experience, compared to traditional methods. Future studies should explore the implementation of regular PPH rescue skill training in real clinical settings to support these findings.
产后出血（PPH）是全球孕产妇死亡的主要原因，因此对PPH抢救技术进行有效培训至关重要。本研究旨在评估基于案例的学习（CBL）、基于问题的学习（PBL）与模拟教学方法相结合在提高助产学员处理PPH技术熟练程度方面的有效性。
这项准实验研究纳入了2023年3月至7月在北京大学第三医院接受PPH培训的76名学员。他们被分为两组：对照组（n = 50）采用传统模拟训练方法，研究组（n = 26）采用CBL-PBL与情景模拟相结合的方法。培训结束后，所有参与者完成理论考试和问卷调查，以评估他们对该课程的满意度以及对PPH临床管理技能的自我评估。使用独立样本t检验和卡方检验进行统计分析以比较两组。
与传统模拟训练相比，CBL-PBL与情景模拟相结合的方法满意度很高，显著提高了研究组助产学员在临床思维（100% 对61.8%，P = 0.03）、与PPH相关的操作技能（100% 对57.4%，P < 0.01）、PPH相关知识（100% 对58.7%，P < 0.01）和管理能力（97.1% 对39%，P < 0.01）方面的自我评估技能，研究组学员在PPH知识的培训后评估中得分也显著高于对照组（91.7 ± 6.0对76.0 ± 7.1，P < 0.01）。大多数学员表示希望在未来的培训课程中定期进行模拟练习（98.7%）并对PPH病例进行详细讨论（93.4%）。
与传统方法相比，将CBL-PBL与模拟实践相结合是一种对具有一定临床经验的产科工作人员进行PPH管理培训更有效的教学方法。未来的研究应探索在实际临床环境中定期开展PPH抢救技能培训以支持这些发现。
