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Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick’s framework: a mixed methods study
  1. Arunaz Kumar1,2,
  2. Sam Sturrock1,
  3. Euan M Wallace2,
  4. Debra Nestel3,
  5. Donna Lucey1,
  6. Sally Stoyles1,
  7. Jenny Morgan1,
  8. Peter Neil1,
  9. Michelle Schlipalius1,
  10. Philip Dekoninck1,4
  1. 1 Monash Women’s Service, Monash Health, Melbourne, Australia
  2. 2 Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
  3. 3 School of Rural Health, Monash University, Melbourne, Australia
  4. 4 The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
  1. Correspondence to Dr Arunaz Kumar; arunaz.kumar{at}monash.edu

Abstract

Objectives The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick’s framework. We explored participants’ acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants’ perception of usefulness of PROMPT in their clinical practice.

Study design Mixed methods approach with a pre-test/post-test design.

Setting Healthcare network providing obstetric care in Victoria, Australia.

Participants Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011–2012 (n=15 361 births) and 2014–2015 (n=12 388 births).

Intervention Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills.

Main outcome measure Clinical outcomes compared before and after embedding PROMPT in educational practice.

Secondary outcome measure Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice.

Results There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies.

Conclusion Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.

  • simulation
  • interprofessional learning
  • interprofessional education
  • evaluation
  • patient outcome

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors AK conceived and designed the study, analysed the data, wrote the first draft of the manuscript and finalised the submission. SamS performed the study, analysed the data, edited the manuscript and approved the final submission. DL, JM, PN, MS and SalS performed the study and approved the final submission. EMW conceived and designed the study, contributed to analysis tools and edited and finalised the submission. DN analysed the data and contributed to analysis tools. PD is the senior author, conceived, designed, performed and supervised the study, analysed data and approved the final submission.

  • Funding The PROMPT programme at Monash Health was supported by funding of the Victorian Managed Insurance Authority (VMIA) when it was introduced.

  • Disclaimer Victorian Managed Insurance Authority had no role in study design, data collection and analysis or manuscript preparation.

  • Competing interests The authors MS, PN, DL, SalS and JM are involved in the delivery of PROMPT at their hospital but have no financial involvement.

  • Patient consent Not required.

  • Ethics approval The study was approved by Monash Human Research Ethics Committee as a quality assurance project.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no additional unpublished data from the study.

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