A Statewide Mobile Simulation Program For Improving Obstetric Skills in Rural Hospitals

Area of Science:

• Medical Simulation
• Rural Health
• Maternal Care

Background:

• Rural obstetric unit closures create maternal care deserts, increasing travel distances for expectant mothers.
• Emergency departments (EDs) in hospitals without obstetric units require ongoing training to maintain skills.
• Rural Level-1 obstetric units with low patient volumes also need regular skill maintenance.

Purpose of the Study:

• To develop and implement a mobile simulation program for obstetric (OB) training in rural settings.
• To enhance OB skills and standardize care using Alliance for Innovation in Maternal Health (AIM) Patient Safety Bundles.
• To address the training needs of both Level-1 OB units and EDs without OB services.

Main Methods:

• A mobile simulation unit was developed following needs assessments.
• A train-the-trainer curriculum was created for Level-1 OB units, including task trainers and virtual workshops.
• In situ simulations were conducted for Level-1 OB unit staff and ED staff, with virtual didactics for EDs.

Main Results:

• 98% of participants agreed workshop goals were met; 95% improved simulator knowledge.
• Level-1 OB unit staff reported a 30% increase in postpartum hemorrhage (PPH) management ability.
• ED staff showed improved basic OB knowledge (95.4%) and team skills in caring for pregnant patients (>95%).

Conclusions:

• The mobile simulation program successfully improved skills for managing simulated PPH and OB emergencies.
• Training enhanced the capabilities of hospital staff in Level-1 OB units and EDs lacking OB services.
• Further research is needed to evaluate the impact on actual maternal outcomes.