Managing women with acute physiological deterioration: student midwives performance in a simulated setting

Cooper, Simon, Bulle, Bree, Biro, Mary Anne, Jones, Janet, Miles, Maureen, Gilmour, Carole, Buykx, Penny, Boland, Rosemarie, Kinsman, Leigh, Scholes, Julie and Endacott, Ruth 2012, Managing women with acute physiological deterioration: student midwives performance in a simulated setting, Women and birth, vol. 25, no. 3, pp. 27-36, doi: 10.1016/j.wombi.2011.08.009.

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Title Managing women with acute physiological deterioration: student midwives performance in a simulated setting
Author(s) Cooper, Simon
Bulle, Bree
Biro, Mary Anne
Jones, Janet
Miles, Maureen
Gilmour, Carole
Buykx, Penny
Boland, Rosemarie
Kinsman, Leigh
Scholes, Julie
Endacott, Ruth
Journal name Women and birth
Volume number 25
Issue number 3
Start page 27
End page 36
Total pages 10
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2012-09
ISSN 1878-1799
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Patient deterioration
Situation awareness
Summary OBJECTIVE: Midwives' ability to manage maternal deterioration and 'failure to rescue' are of concern with questions over knowledge, clinical skills and the implications for maternal morbidity and, mortality rates. In a simulated setting our objective was to assess student midwives' ability to assess, and manage maternal deterioration using measures of knowledge, situation awareness and skill, performance. METHODS: An exploratory quantitative analysis of student performance based upon performance, ratings derived from knowledge tests and observational ratings. During 2010 thirty-five student, midwives attended a simulation laboratory completing a knowledge questionnaire and two video, recorded simulated scenarios. Patient actresses wearing a 'birthing suit' simulated deteriorating, women with post-partum and ante-partum haemorrhage (PPH and APH). Situation awareness was, measured at the end of each scenario. Applicable descriptive and inferential statistical tests were, applied to the data. FINDINGS: The mean total knowledge score was 75% (range 46-91%) with low skill performance, means for both scenarios 54% (range 39-70%). There was no difference in performance between the scenarios, however performance of key observations decreased as the women deteriorated; with significant reductions in key vital signs such as blood pressure and blood loss measurements. Situation, awareness scores were also low (54%) with awareness decreasing significantly (t(32)=2.247, p=0.032), in the second and more difficult APH scenario. CONCLUSION: Whilst knowledge levels were generally good, skills were generally poor and decreased as the women deteriorated. Such failures to apply knowledge in emergency stressful situations may be resolved by repetitive high stakes and high fidelity simulation.
Language eng
DOI 10.1016/j.wombi.2011.08.009
Field of Research 111006 Midwifery
Socio Economic Objective 920210 Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, Australian College of Midwives
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Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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