Akroyd M, Jordan G, Rowlands P. Interprofessional, simulation-based technology-enhanced learning to improve physical healthcare in psychiatry: the RAMPPS course. Health Informatics J. 2016; 22:(2)397-405

Arundell F, Cioffi J. Using a simulation strategy: an educators experience. Nurse Educ Pract. 2005; 5:(5)296-301

Cioffi J, Purcal N, Arundell F. A pilot study to investigate the effect of a simulation strategy on the clinical decision making of midwifery students. J Nurs Educ. 2005; 44:(3)131-4

Coffey F. Learning by simulation – is it a useful tool for midwifery education?. New Zealand College of Midwives Journal. 2015; 51:30-6

Davys D, Jones V. Peer observation: A tool for continuing professional development. Int J Ther Rehabil. 2007; 14:(11)489-493

Dow A. Simulation-based learning: a case study, part 1. British Journal of Midwifery. 2012; 20:(7)508-14

Elfrink VL, Kirkpatrick B, Nininger J, Schubert C. Using learning outcomes to inform teaching practices in human patient simulation. Nurs Educ Perspect. 2010; 31:(2)97-100

Fransen AF, van de Ven J, Merién AER Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial. BJOG. 2012; 119:(11)1387-93

Garden AL, Le Fevre DM, Waddington HL, Weller JM. Debriefing after simulation-based non-technical skill training in healthcare: a systematic review of effective practice. Anaesth Intensive Care. 2015; 43:(3)300-8

Hamman WR. The complexity of team training: what we have learned from aviation and its applications to medicine. Qual Saf Health Care. 2004; 13:i72-9

Kortum P. Has human factors and usability lost its mojo?. Journal of Usability Studies. 2017; 12:(2)

Kumar A, Gilmour C, Nestel D, Aldridge R, MCLelland G, Wallace E. Can we teach core clinical obstetrics and gynaecology skills using low fidelity simulation in an multidisciplinary setting?. Aust N Z J Obstet Gynaecol. 2014; 54:(6)589-92

Lateef F. Simulation-based learning: just like the real thing. J Emerg Trauma Shock. 2010; 3:(4)348-52

Lathrop A, Winningham B, Vandevusse L. Simulation-based learning for midwives: background and pilot implementation. J Midwifery Womens Health. 2007; 52:(5)492-8

Loureiro I, Sherriff N, Davies JK. Developing public health competencies through building a problem-based learning project. J Public Health (Bangkok). 2009; 17:(6)417-24

Manktelow BN, Smith LK, Prunet C MBRRACE-UK Perinatal Mortality Surveillance Report: Perinatal Deaths for Births from January to December 2015.Leicester: Department of Health Sciences, University of Leicester; 2017

Mason J, Davies S. A qualitative evaluation of a preceptorship programme to support newly qualified midwives. Evidence Based Midwifery. 2013; 11:(3)94-8

Murphy Tighe S, Bradshaw C. Peer-supported review of teaching: making the grade in midwifery and nursing education. Nurse Educ Today. 2013; 33:(11)1347-51

Hypertension in pregnancy: diagnosis and management [CG107].London: NICE; 2011

National Patient Safety Agency. Organisation Patient Safety Incident Reports – data workbooks Sept 2013. 2013. (accessed 14 November 2017)

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

Norris G. The midwifery curriculum: introducing obstetric emergency simulation. British Journal of Midwifery. 2008; 16:(4)232-5

Standards for pre-registration midwifery education.London: NMC; 2009

Self-reflection: foundation for meaningful nursing practice. 2013. (accessed 14 November 2017)

Pauley T, Dale A. Train together to work together: reviewing feedback of community-based skills drills training for midwives and paramedics. British Journal of Midwifery. 2016; 24:(6)428-32

Ramani S, Krackov SK. Twelve tips for giving feedback effectively in the clinical environment. Med Teach. 2012; 34:(10)787-91

Shoulder Dystocia [Green Top Guideline No. 42], 2nd edn. London: RCOG Press; 2012

Royal College of Obstetrics and Gynaecologists. Joint RCOG/RCM statement on multi-disciplinary working and continuity of carer. 2016. (accessed 14 November 2017)

Sabus C, Macauley K. Simulation in physical therapy education and practice opportunities and evidence-based instruction to achieve meaningful learning outcomes. Journal of Physical Therapy Education. 2016; 30:(1)

Scholes J, Endacott R, Biro M Clinical decision-making: midwifery students recognition of, and response to, post partum haemorrhage in the simulation environment. BMC Pregnancy Childbirth. 2012; 12:(1)

Thompson S, Neal S, Clark V. Clinical risk management in obstetrics: eclampsia drills. Qual Saf Health Care. 2004; 13:(2)127-9

Van Wagner V. Using simple simulation to teach midwifery skills. Canadian Journal of Midwifery Research and Practice. 2012; 11:(1)

Yuill L. Simulation in midwifery education: not just a passing trend. British Journal of Midwifery. 2017; 25:(3)142-3

Obstetric emergencies: Enhancing the multidisciplinary team through simulation

02 February 2018
Volume 26 · Issue 2



The multidisciplinary team facilitated simulation sessions that took place within a local Trust during a study day called ‘Managing the sick obstetric patient’ and during annual training of maternity staff.


To discuss and analyse the importance of the using the multidisciplinary team during high fidelity simulation. The aim was to review how effective the staff thought the simulation was in supporting them to enhance their skills working as a team.


Following the simulation session with the multidisciplinary team, a feedback sheet in the form of a questionnaire was given to all participants of the study day to evaluate its effectiveness. The themes were then derived from the data for analysis.


The main themes that were highlighted were: ‘improved team working’, ‘realism’, and ‘helpful refresher’. There were also three sub-themes that emerged from data collection: ‘feedback was practical and efficient’, ‘increased confidence and communication skills’, and ‘could be made more realistic’.


High fidelity simulation plays a major role in training and assessing the competence of staff. Staff valued the simulation and reported that they achieved increased confidence and communication skills as a result of participating.

This article will discuss the use of high fidelity simulation in Southport and Ormskirk Hospital Trust in the north west of England. High fidelity simulation is used in the Trust for a few different purposes: during the biannual study day on ‘Managing the sick obstetric patient’, for live skills and drills on the maternity wards, and during the annual emergency training, which is incorporated into the mandatory training of staff. Each of these occasions includes the multidisciplinary team.

Simulation-based training was initially introduced to improve patient safety, addressing the factors surrounding substandard care during clinical incidents, while reducing clinical litigation (Fransen et al, 2012; National Patient Safety Agency, 2013). Lathrop et al (2007) suggest that poor teamwork is the cause of many critical incidents in health settings, and having a simulated learning environment where no harm can be caused is crucial in building experience and enhancing competence and confidence. Maternal death in the UK has been linked with poor standards of care and a lack of training to recognise acute emergencies or the ‘sick obstetric patient’, including failure to start treatment promptly (Manktelow et al, 2017). Simulation is proven to reduce clinical risk (Thompson et al, 2004) and results in enhanced teamwork and team performance (Fransen et al, 2012). As the National Maternity Review (NHS England, 2016), clearly states that ‘those who work together should train together’, simulation plays an important role in both undergraduate midwifery education and continuing professional development. Simulation therefore has a role to play in training staff to deal with emergencies effectively with a view to avoid and reduce maternal mortality and morbidity in the UK.

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