Simulation-Based Outreach Program to Support Community Hospitals’ Team Readiness for Obstetric Emergencies Across a Rural Health System

BackgroundRural hospitals face persistent challenges in sustaining readiness for obstetric emergencies due to declining birth volumes, workforce shortages, and limited opportunities for hands-on practice.The Maine Obstetrical Medical Simulation (MOMSim) program was developed to support interprofessional team preparedness across a rural health system.This study evaluated program implementation and its impact on participants' confidence in managing obstetric emergencies. MethodologyAn in situ, simulation-based obstetric emergency training program was delivered across eight community hospitals within a rural health system from 2022 to 2025.Each site received two half-day training visits approximately one year apart.The curriculum incorporated targeted skills stations, high-fidelity in situ simulations, and structured debriefings.Participant demographic information was collected, and anonymous pre-and post-training surveys assessed confidence across multiple domains on a five-point Likert scale.Linear mixed-effects models evaluated aggregate pre-and post-training changes across sites and visits and differences in baseline confidence between the first and second visit; confidence was also compared across hospital sites and professions. ResultsAcross 16 training sessions, 287 interprofessional participants engaged in the program.Confidence increased significantly across all assessed domains following training, with mean improvements ranging from 0.24 (95% confidence interval (CI) = 0.11-0.37) to 0.51 (95% CI = 0.35-0.68)Likert points.No significant differences in baseline confidence were observed between visits.Pre-training comparisons between sites identified significant differences in perceived resources, team confidence, and team cohesion. ConclusionsThe MOMSim program was successfully implemented across a geographically dispersed rural health system and was associated with significant improvements in interprofessional team confidence.Systemwide simulation outreach may provide a feasible approach to strengthening obstetric emergency preparedness and team-based readiness of low-volume rural delivery units.