Improving Confidence in Management of Maternal Cardiac Arrest through Simulation

Objective

To assess the effectiveness of a maternal cardiac arrest (MCA) training video and simulation in improving self-reported confidence in managing MCA among Labor and Delivery (L&D) staff Background: MCA is a rare but devastating pregnancy outcome, occurring in approximately 1 in 9000 deliveries. Given its low incidence, additional training for L&D physicians and nurses is needed to ensure rapid recognition of and response to MCA. Simulation is increasingly recognized as an important tool for improving knowledge, teamwork, and confidence in responding to uncommon obstetric emergencies. Materials and Methods: An eight-minute MCA simulation educational video was created that is specific to our L&D unit. After IRB approval (exempt), L&D staff were invited to view the video followed immediately by a live simulation. All physician and nursing staff present on the Labor and Delivery floor at the time of simulation were invited to participate. Participants first completed a one question survey rating their confidence in performing their role in managing MCA on a 5-point Likert scale. Participants then viewed the instructional video. Participants next completed the MCA simulation, followed by a debrief. A low fidelity pregnant mannequin was available, as was a crash cart, AED, medications, and surgical instruments. The location was a typical labor room. Finally, participants completed a two-question survey rating their post-simulation confidence in performing their role in managing MCA and the usefulness of the video and simulation on a 5-point Likert scale. Pre- and post-simulation confidence scores were compared using a paired t-test (α=0.05).