Mono-Professional Simulation-Based Obstetric Training in a Low-Resource Setting: Stepped-Wedge Cluster Randomized...

Area of Science:

• Medical Education
• Obstetrics and Gynecology
• Public Health

Background:

• Emergency obstetric simulation-based training is vital for improving care in sub-Saharan Africa.
• High-quality research is essential to optimize training methodologies in resource-limited settings.

Purpose of the Study:

• To evaluate the impact of a train-the-trainer model for technology-enhanced, mono-professional obstetric simulation training on maternal and perinatal outcomes in a resource-constrained environment.

Main Methods:

• A stepped-wedge cluster randomized trial was conducted in Uganda with over 23,000 annual deliveries.
• The intervention involved cascading training from master trainers to local facilitators and then to senior house officers.
• Training included technical and teamwork skills, with outcomes measured by mortality rates and adverse event scores.

Main Results:

• The combined maternal and perinatal mortality rate was similar between the intervention (9.05%) and control (8.73%) groups.
• No statistically significant differences were observed in maternal mortality, perinatal mortality, or rates of vacuum extraction and cesarean section.

Conclusions:

• The train-the-trainer model did not significantly alter maternal and perinatal mortality outcomes.
• Further research should investigate multiprofessional team training involving all unit staff for improved obstetric care.