Emergency obstetric health care Pregnancy and Childbirth Emergency obstetric healthcare
Conditions
Interventions
This is a stepped-wedge trial with 7 study groups, which will be cluster-randomised to receive the intervention by a computer-generated random sequential roll-out of the training sessions over time.
Sponsors
Mulago National Referral Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Senior house officer (resident) 2. Work at the medium to high-risk maternity ward of the Mulago hospital 3. Aged 18 years or older 4. Fluent in English
Exclusion criteria
Exclusion criteria: None
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Combined mortality proportion (CMP), measured using Mulago Hospital registration books, measured repeatedly during periods of 7 weeks from the start of the trial (with the exception of holiday and exam periods): 1. Maternal mortality ratio (MMR) - the number of maternal deaths per 100,000 live births 2. Perinatal mortality (PMR) - the number of stillbirths and deaths in the first week of life per 1000 live births In Mulago hospital only deliveries with a gestational age of 28 weeks or more or a birth weight of more than one kilogram are registered. These deliveries will be included in the analysis. | — |
Secondary
| Measure | Time frame |
|---|---|
| The following were measured repeatedly during periods of 7 weeks from the start of the trial (with the exception of holiday and exam periods): 1. Perception of trainees in the training program, assessed using a 42-item questionnaire about ten instructional design features of the training program including feedback, repetition, curriculum integration, difficulty range, learning strategies, clinical variation, controlled environment, individualization, defined outcomes, and simulator validity (the ID-SIM). The data will be treated as ordinal data at the item level. Suggestions for improvement can be made in an open remark. Participants are asked to complete this at the end of the full-day main training 2. Knowledge of SHOs about technical and non-technical emergency obstetric skills, assessed using 30-item multiple choice knowledge test at the onset and end of the full day of training 3. Clinical performance in the simulated postpartum haemorrhage scenarios, assessed by independent Dutch simulation instructors through reviewing the videotaped training sessions of the full-day main training. A skills checklist based on literature and clinical experience will be used and assessors will be blind to the day of training and whether the scenario was the first or last of the day. The mean score of the clinical performance of the first and last scenario of the SHOs' main training will be compared. 4. Team performance, assessed by independent Dutch simulation instructors through reviewing the videotaped training sessions of the full-day main training. The Clinical Teamwork Scale (CTS) will be used, which contains questions about communication, situational awareness, decision-making, role responsibility, and patient friendliness. Assessors will be blind to the day of training and whether the scenario was the first or last of the dayThe mean score of the clinical performance of the first and last scenario of the mai | — |
Countries
Uganda
Outcome results
None listed