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Volume 29 (2)

Volume 29, Issue 2, Spring 2009line
J Contin Educ Health Prof 2009; 29(2):104
ORIGINAL RESEARCH

Multidisciplinary obstetric simulated emergency scenarios (MOSES): Promoting patient safety in obstetrics with teamwork-focused interprofessional simulations
Della Freeth, Gubby Ayida, Emma Jane Berridge, Nicola Mackintosh, Beverley Norris, Chris Sadler, Alasdair Strachan

A b s t r a c t

Introduction: We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined.
Methods: Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England. Telephone or e-mail interviews with MOSES course participants and facilitators were conducted, and video-recorded debriefings that formed integral parts of this 1-day course were analyzed.
Results: The team training was well received. Participants were able to check out assumptions and expectations of others and develop respect for different roles within the delivery suite (DS) team. Skillful facilitation of debriefing after each scenario was central to learning. Participants reported acquiring new knowledge or insights, particularly concerning the role of communication and leadership in crisis situations, and they rehearsed unfamiliar skills. Observing peers working in the simulations increased participants' learning by highlighting alternative strategies. The learning achieved by individuals and groups was noticeably dependent on their starting points. Some participants identified limited changes in their behavior in the workplace following the MOSES course. Mechanisms to manage the transfer of learning to the wider team were weakly developed, although 2 DS teams made changes to their regular update training.

Lessons for Practice
  • With skilled facilitation it is possible to create a positive interprofessional learning environment for participants to learn with, from, and about each other, developing team working in support of patient safety.
  • Simulation is a valuable approach for team-based education focused on nontechnical skills. It offers protected time for team reflection, rehearsal of alternatives, and scope to observe as well as participate.
  • Attention to mechanisms supporting transfer to practice is important.

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