Assistant Dean of Simulation University of Tennessee Knoxville, Tennessee, United States
Disclosure(s):
Susan H. Hébert, PhD, RN, CHSE: No financial relationships to disclose
Abstract :
Introduction: Annual neonatal deaths remain at 17 per 1000 births globally and researchers found this is partly due to inaccuracies in the interpretation of electronic fetal monitoring (EFM) tracings and the quality of training and evaluation to confirm competence in EFM interpretation.
Methods: The study, a randomized controlled design, associated participant baseline competence to demographic characteristics and included a Simulation Based Mastery Learning (SBML) intervention. Two post-intervention evaluations measured competence at one month and three months.
Results: Medium effect associations were present between baseline scores, level of education (r=.36) and EFM training (r=.33). Correlations between competence scores and clinical experience (r=-.20) and obstetric experience (r=-.16) showed a moderate inverse relationship. Univariate comparisons between groups across time showed significant results one month post-intervention (p=.006) but not at three months. Between group comparisons showed significance in correctness of interpretations evaluating marked fetal heart rate (FHR) variability (p=.016; p=.029; p=.024) and Category III tracings (p=.002), and comparisons across three times were significant for FHR moderate variability (p=.029; p=.044), FHR minimal variability (p=.004), FHR marked variability (p=.007), FHR prolonged deceleration (p=.004), three Category II tracings (p=.043; p=.043; p=.041), and one Category III tracing (p=.047). The intervention group scored higher percentages of correct responses to interpretation of tracings for all criteria questions showing significance in both between group and time comparisons.
Conclusions: Regardless of study limitations, the results provide critical insight into the feasibility of using a SBML with DP intervention as an approach to promote improved accuracies and consistencies in interpretation of EFM tracings.
Learning Objectives:
By the end of the session, learners will be able to summarize the current state of training and evaluation to sustain competence in interpretation of EFM tracings.
By the end of the session, learners will explore the methods and outcomes of using a Simulation-Based Mastery Learning approach to enhance interpretation of EFM tracings.
By the end of the session, learners will be empowered to imagine other health care-related skills to consider when applying a SBML approach to skill training and sustaining mastery.
