Practical obstetric multi-professional training (PROMPT): the evidence for effective training

Area of Science:

• Obstetrics and Gynecology
• Medical Education
• Patient Safety

Background:

• Multi-professional training in labor wards shows variable effectiveness, sometimes worsening outcomes.
• Adequate training with outcome monitoring is essential for improvement.
• PROMPT training comprises 14 modules focused on teamwork, communication, and clinical skills for various obstetric emergencies.

Purpose of the Study:

• To evaluate the effectiveness of Practical Obstetric Multi-Professional Training (PROMPT).

Main Methods:

• Systematic literature review of studies from January 2000 to November 2024.
• Searched PubMed, Embase, Medline, Scopus, and Cochrane Library.
• Included randomized controlled trials, observational cohorts, and quasi-experimental designs; assessed quality using Cochrane Risk of Bias tool.

Main Results:

• 37 out of 42 studies reported improvements across 8/14 PROMPT modules.
• Key improvements include enhanced teamwork, shoulder dystocia management, reduced hypoxic-ischaemic encephalopathy, better pre-eclampsia management, and faster delivery for cord prolapse.
• Evidence of reduced litigation costs and cost-effectiveness was found; however, three studies showed no significant improvement, and one reported worsened outcomes.

Conclusions:

• PROMPT training effectively reduces adverse outcomes in rare, severe obstetric complications.
• Effective implementation requires authentic PROMPT materials, integrated team and communication training.
• Annual, multi-professional retraining is crucial for sustained positive impact.