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


Cooper, S and Bulle, B and Biro, MA and Jones, J and Miles, M and Gilmour, C and Buykx, P and Boland, R and Kinsman, L and Scholes, J and Endacott, R, Managing women with acute physiological deterioration: Student midwives performance in a simulated setting, Women and Birth, 25, (3) pp. e27 e36. ISSN 1871-5192 (2012) [Refereed Article]

Copyright Statement

Copyright 2011 Australian College of Midwives

DOI: doi:10.1016/j.wombi.2011.08.009


Objective: Midwives’ ability to manage maternal deterioration and ‘failure to rescue’ are of concern with questions over knowledge, clinicalskills and the implicationsfor 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.

Item Details

Item Type:Refereed Article
Keywords:education; midwifery; simulation; patient deterioration; decision making; situation awareness
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Nursing
UTAS Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:97780
Year Published:2012
Web of Science® Times Cited:23
Deposited By:Health Sciences B
Deposited On:2015-01-13
Last Modified:2017-11-06

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