Asche CV, Kim M, Brown A Communicating value in simulation: cost-benefit analysis and return on investment. Acad Emerg Med. 2018; 25:(2)230-237

Brackmann MW, Andreatta P, McLean K, Reynolds RK. Development of a novel simulation model for assessment of laparoscopic camera navigation. Surg Endosc. 2017; 31:(7)3033-3039

Burton R, Hope A. Simulation based education and expansive learning in health professional education: A discussion. Journal of Applied Learning and Teaching. 2018; 1:(1)

Carolan-Olah M, Kruger G, Brown V, Lawton F, Mazzarino M, Vasilevski V. Communicating out loud: Midwifery students' experiences of a simulation exercise for neonatal resuscitation. Nurse Educ Pract. 2018; 29:8-14

Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney S Publication guidelines for quality improvement in health care: evolution of the SQUIRE project. Qual Saf Health Care. 2008; 17:i3-i9

Safer Maternity Care: The National Maternity Safety Strategy—Progress and Next Steps.London: DHSC; 2017

Draper ES, Kurinczuk JJ, Kenyon S. MBRRACE-UK Perinatal Confidential Enquiry: Term, singleton, intrapartum stillbirth and intrapartum-related neonatal death.Leicester: Department of Health Sciences, University of Leicester; 2017

Freedman RL, Lucas DN. MBRRACE-UK: saving lives, improving mothers' care - implications for anaesthetists. Int J Obstet Anesth. 2015; 24:(2)161-173

Flenady V, Middleton P, Smith GC Stillbirths: the way forward in high-income countries. Lancet. 2011; 377:(9778)1703-1717

Flin R, Patey R, Glavin R, Maran N. Anaesthetists' non-technical skills. British Journal of Anaesthesia. 2010; 105:(1)38-44

Gavin NR, Satin AJ. Simulation training in obstetrics. Clin Obstet Gynecol. 2017; 60:(4)802-810

Gleddie M, Stahlke S, Paul P. Nurses' perceptions of the dynamics and impacts of teamwork with physicians in labour and delivery. Journal of Interprofessional Care. 2018; 1-11

Hayes C, Hinshaw K, Petrie K. Reconceptualizing medical curriculum design in strategic clinical leadership training for the 21st century physician. In: Storey VA, Beeman TE (eds). Hershey (PA): IGI Global; 2019

Kay J. Using the Chapelhow Framework to Deliver Nursing Care. Links to Health and Social Care. 2018; 3:(2)4-23

Kluger MT, Laidlaw TM, Kruger N, Harrison MJ. Personality traits of anaesthetists and physicians: an evaluation using the Cloninger Temperament and Character Inventory (TCI-125). Anaesthesia. 1999; 54:(10)926-935

Knight M. Key messages from the UK and Ireland confidential enquiries into maternal death and morbidity 2015. The Obstetrician & Gynaecologist. 2015; 18:(1)

Kudson MM, Khaw L, Bullard MK. Trauma training in simulation: translating skills from SIM time to real time. J Trauma. 2008; 64:(2)255-63

Lawn JE, Blencowe H, Waiswa P Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016; 387:(10018)587-603

Merién AER, van de Ven J, Mol BW, Houterman S, Oei SG. Multidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review. Obstet Gynecol. 2010; 115:(5)1021-31

Mol BWJ, Roberts CT, Thangaratinam S, Magee LW, de Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2015; 387:(10022)999-1011

Myer ENB, Chen CCG. Obstetrics and Gynecology Simulation and Global Health Initiatives. In: Deering S, Auguste T, Goffman D (eds). Cham: Springer; 2019

Better Births: Improving Outcomes of Maternity Services in England.London: NHS England; 2016

The Code: Professional standards of practice and behaviour for nurses and midwives.London: NMC; 2018

Pinar SE, yildirim G, Sayin N. Investigating the psychological resilience, self-confidence and problem-solving skills of midwife candidates. Nurse Educ Today. 2018; 64:144-149

Riley W, Davis S, Miller KM, Hansen H, Sweet RM. Detecting breaches in defensive barriers using in situ simulation for obstetric emergencies. Qual Saf Health Care. 2010; 19:i53-6

Rivera-Chiauzzi E, Ugbomah C, Moore-Murray T, Goffman D, Bernstein P, Bajaj K. Lessons From a randomized control trial. Obstet Gynecol. 2016; 127:17S-18S

Robertson JE, Lisonkova S, Lee T Fetal, infant and maternal outcomes among women with prolapsed membranes admitted before 29 weeks gestation. PLoS One. 2016; 11:(12)

Satin AJ. Simulation in obstetrics. Obstet Gynecol. 2018; 132:(1)199-209

Sørensen J, Van der Vleuten C, Lindschou J ‘In situ simulation’ versus ‘off site simulation’ in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial. Trials. 2013; 14:(1)

Thompson S, Neal S, Clark V. Clinical risk management in obstetrics: eclampsia drills. BMJ. 2004; 328:(7434)269-271

yau CWH, Pizzo E, Morris S The cost of local, multi-professional obstetric emergencies training. Acta Obstet Gynecol Scand. 2016; 95:(10)1111-1119

Evaluating the contribution of interdisciplinary obstetrics skills and drills emergency training

02 March 2019
18 min read
Volume 27 · Issue 3



High-fidelity simulation is integral to health professional training. The effect of interdisciplinary training on levels of confidence in obstetric emergencies is less well explored.


To evaluate the impact of a multidisciplinary training project in obstetric emergency skills and drills on the confidence of staff.


A mixed-methods approach was used to evaluate the self-reported confidence levels of obstetrics staff. A total of 69 staff voluntarily attended emergency skills and drills training with a birthing simulator manikin. The programme used four emergency scenarios that had potential for poor maternal outcomes. A debrief followed each scenario and confidence levels were self-reported before and after each training session.


There were significant (P<0.05) effects on teams' self-perceived confidence levels. Staff reported that training improved their knowledge and understanding of interdisciplinary roles, and improved capacity within and between professional disciplines.


This model is of significant use in interdisciplinary obstetric emergency care training. Training had a direct effect on the staff's perceived confidence and encouraged critical reflection on professional practice in emergency obstetrics.

Variation in the quality of maternal health and perinatal care provision was highlighted by the Government's initiative to reduce the stillbirth and neonatal death rate by 50% by 2025 and 20% by 2020 (Department of Health, 2017). While a consistent decrease in these mortality rates has been evident over time, a similar decrease was not seen in City Hospitals Sunderland NHS Trust. Research (Knight, 2016) identified that emergency obstetric practices could be targeted for intervention, and therefore, identifying areas for quality improvement in standards of emergency obstetric practice and implementing a robust training programme in collaboration with City Hospitals Sunderland NHS Trust became key priorities.

The issues surrounding the effective management of conditions such as eclampsia and pre-eclampsia are well known (Mol et al, 2015). In the context of risk and human factors analysis, further investigation into how interdisciplinary emergency skills and drills training affects collaborative working in obstetrics was needed. Clinical simulation has provided a way of showing improvements in obstetric care, with core educational principles adopted in the form of human factors training, guided by professional curricula (Nursing and Midwifery Council (NMC), 2018). This has been highlighted in several reports (Freedman et al, 2015; National Maternity Review, 2016).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month