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Related Experiment Video

Updated: Feb 25, 2026

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Cost-effectiveness of simulation-based team training in obstetric emergencies (TOSTI study).

J van de Ven1, G J van Baaren2, A F Fransen3

  • 1Department of Obstetrics and Gynaecology, Elkerliek Hospital, Helmond, The Netherlands.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|August 2, 2017
PubMed
Summary

Obstetric multi-professional team training in simulation centers is cost-effective, especially with on-site repetition. Regular, repeated training significantly reduces obstetric complications and neonatal trauma, proving more beneficial than single sessions.

Keywords:
Cost-effectivenessObstetric careRandomised controlled trialSimulationTeam training

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Area of Science:

  • Medical Simulation
  • Healthcare Management
  • Obstetrics

Background:

  • Team training is a common practice in obstetrics.
  • Evaluating the economic viability of such training is crucial for healthcare systems.

Purpose of the Study:

  • To assess the cost-effectiveness of obstetric multi-professional team training conducted in a medical simulation center.
  • To compare different training repetition strategies.

Main Methods:

  • A model-based cost-effectiveness analysis was performed from a hospital perspective.
  • Four strategies were evaluated: no training, training without repetition, and training with 6-month or 3-6-9-month repetitions.
  • Incremental Cost-Effectiveness Ratios (ICERs) were calculated for composite obstetric complications and neonatal trauma from shoulder dystocia.

Main Results:

  • A single day of training cost €25,546 per hospital.
  • Repetition training strategies were more effective and less costly than single training sessions.
  • ICERs to prevent composite obstetric complications were €3432 (6-month repetition) and €5115 (3-monthly repetition).
  • ICER for preventing neonatal trauma due to shoulder dystocia with 3-monthly repetition was €22,878.

Conclusions:

  • Multi-professional team training in simulation centers is cost-effective.
  • On-site repetition of training sessions is key to this cost-effectiveness.