Simulation training in Obstetric emergencies
Dr. Thomas Kou Associate consultant, O&G, QEH
7th May 2012
Meeting the challenges
Influx of mainland China expectant mothers -> overwhelm Obstetric, neonatology, ICU services, etc
HA decreased quota for non-entitled persons (NEP) since April 2011
Dramatic increase in non-booked labouring patients attending A&E at the last minute
Meeting the challenges
Meeting the challenges
Meeting the challenges
Pose an unique and important challenge to A&E department
Less familiar with delivery process
High risk of complications: No regular antenatal checkup In advanced labour Antenatal complications are not
managed properly eg. Big baby, growth restriction, gestational diabetes, etc.
How to meet the challenges?
Design
The solution is to provide simulation training
A multidisciplinary team
Obstetricians
Midwives
Paediatricians
A&E staff
Multi-Disciplinary Simulation and Skills Centre (MDSSC)
Design
Target:
Schedule
16th September 2011
9th December 2011
27th March 2012
Coming 3 more sessions
All A&E doctors and nurses
Design
Why simulation training? Low cost
High fidelity
Better engagement of trainees
Promising study results on obstetric simulation training
Venue: Multi-Disciplinary Simulation and Skills Centre of QEH
Design
Stations:
1. Managing a normal spontaneous delivery
2. Shoulder dystocia
3. Cord prolapse
4. Neonatal resuscitation
Design
Trainee manuals: pre-reading
Lectures (15 minutes on each topic)
Hand-on practices
Debriefing
Station 1: Normal spontaneous delivery
Station 2: Shoulder dystocia
Station 3: Cord prolapse
Station 4: Neonatal resuscitation
Evaluations
Total participants: 61
Doctors : 20 (33%) Nurses : 41 (67%) Return of evaluation forms : 59/61 (97%)
No. of doctors No. of Nurses Total
16th Sept 2011 8 13 21
9th Dec 2011 5 16 21
27th Mar 2012 7 12 19
Evaluations
Questions Yes No
1. The program was useful and informative 59/59 (100%) 0/59
2. The aims and objectives were clear 59/59 (100%) 0/59
3. Learning objective were achieved 59/59 (100%) 0/59
4. The learning-teaching activities were congruent which the overall program objectives and content
59/59 (100%) 0/59
5. The presenter/speaker/facilitator have demonstrated up-to-date professional knowledge and expertise
59/59 (100%) 0/59
6. The teaching method was appropriate 59/59 (100%) 0/59
7. The facility (e.g. venue) was appropriate 59/59 (100%) 0/59
8. The length of the program was: Too long About right Too short
0/59 56/59 (95%) 3/59 ( 5%)
Evaluations
Other comments:
Extend the workshop to full day session
Videos can be added
Add vaginal breech delivery/pre-eclampsia
Clinical attachment to labour room
Conclusions
Feedbacks from trainees and trainers are encouraging and reflect high satisfaction
The workshop will be run regularly to meet the demand and enhance A&E staff’s competency in managing obstetric emergencies
Future
? More NEP attending A&E in 2013 after quota becomes zero
Extend to A&E in other hospitals which are without obstetric support (8 HA hospitals)
More types of emergencies scenarios