Building Capacity of Emergency Medicine Providers to Manage Obstetric Emergencies in Ohio: An Opportunity to Reduce Maternal Morbidity and Mortality

Full Description: The goal of this train-the-trainer project was to train providers in emergency medicine to effectively use simulation methods for training their clinicians and staff in the management of obstetric emergencies. In Ohio, 23% of pregnancy-related deaths that occurred during the time period of 2008-2016 happened in an emergency department or an outpatient setting and 41% of pregnancy-related deaths from 2010-2016 involved a maternal transport. Thus, emergency medicine providers and staff are usually the first to see pregnant and postpartum patients who are experiencing obstetric emergencies.
From August 2020 until September 2021, the Clinical Skills Education and Assessment Center (CSEAC) of The Ohio State University conducted four virtual train the trainer sessions with a focus on emergency medicine providers learning to use simulation to manage obstetric emergencies. Overall, there were 41 attendees from 19 of Ohio's 88 counties.
The training scenarios covered topics such as team communication, crafting training objectives, and the effective conduct of simulation and debriefing. Training sessions were 8-hours in length and capped at a maximum of 20 participants. Facilitators of the trainings, included a maternal-fetal-medicine physician, an emergency medicine physician, and an emergency medicine nurse.
Pre-and post-training tests were administered to learners to assess the effectiveness of the training. Post-test scores increased in the following measures: knowledge related to facilitation of obstetric emergency simulations and confidence in the participants’ ability to perform the three components of simulation: development of scenarios, conduct of training and debriefing, and evaluation of outcomes. Relative to knowledge related to the training content, the mean score significantly increased from 3.07 to 3.97 (t[29] = 4.27, p<.001) on a 5-item scale. The overall self-efficacy score significantly increased from pre- to-post training from a mean (SD) of 3.53(0.74) to 4.37(0.43), t(29) = 6.40, p <.001 on a 7 item scale.
When asked to indicate the extent to which they intended to use trained skills on the job, the average score was 6.48 (SD = 0.58), indicating that participants highly intended to use what they learned in the training back at their job. Qualitative responses confirmed satisfaction with the training. By training providers to implement training in obstetric emergencies at their home institutions, the training can be amplified to reach more providers in more geographic locations. These trainings augment direct clinical trainings of providers and ultimately lead to greater numbers of providers adept in the management of obstetric emergencies.

Abbreviated Description: The goal of this train-the-trainer project was to train providers in emergency medicine to effectively use simulation methods for training their clinicians and staff in the management of obstetric emergencies. The Clinical Skills Education and Assessment Center of The Ohio State University conducted four virtual train the trainer sessions with a focus on emergency medicine providers learning to use simulation to manage obstetric emergencies. Pre-and post-training tests were administered to learners. Post-test scores increased in the following measures: knowledge related to facilitation of obstetric emergency simulations and confidence in the participants’ ability to perform simulation: development of scenarios, conduct of training and debriefing, and evaluation of outcomes.