Education and Evaluation of Electronic Fetal Monitor Interpretation: A Scoping Review

Current education and evaluation methods to support safe monitoring and interpretation of electronic fetal monitoring (EFM) tracings lack rigor. The purpose of this scoping review was to assess the state of EFM education and competence evaluation.

A systematic search was conducted of peer-reviewed articles between January 2011 and December 2023 using CINAHL, PubMed, and Web of Science. The publications reviewed included findings on EFM education and competence evaluation. Data were synthesized into identified themes.

The search produced 192 initial publications, and after review and analysis, nine were included in the final analysis. The themes identified included educational and evaluation methods and the curricular design. The type of competence evaluation used and the inclusion of essential EFM interpretation components were noted. Processes for the development of curricula and the use of an educational theory were also highlighted. The definition of competence, the effectiveness of educational interventions and evaluation measures, and the inclusion of intra- and interrater consistencies of interpretations were identified as key themes. Of the interventional studies, most used e-learning or a hybrid method including e-learning. An evaluation tool measured effectiveness in most studies; however, many did not set a passing standard. Some operationalized rigorous tools, but few measured the essential components of EFM interpretations or considered interrater consistencies of participants' EFM interpretations.

There is need to improve education and evaluation of EFM tracing interpretation skills after participating in initial fetal monitoring courses, including integrating evidence-based educational design practices and rigorous learner evaluation to ensure safe and accurate EFM interpretations.