Enhancing postpartum hemorrhage training by integrating case-problem based learning with simulation: a quasi experimental study
Creators: name: Yang, Yike
name: Guo, Zhichao
name: Guo, Xiaoyue
name: Zhao, Yangyu
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Cell Biology
subject: Sociology
subject: FOS: Sociology
subject: Immunology
subject: FOS: Clinical medicine
subject: Biological Sciences not elsewhere classified
subject: Mathematical Sciences not elsewhere classified
subject: Science Policy

description: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide, and effective training in PPH rescue techniques is crucial. This study aims to evaluate the effectiveness of combining case-based learning (CBL) and problem-based learning (PBL) with simulation teaching methods in improving midwifery trainees’ technical proficiency in managing PPH. This quasi-experimental study involved 76 trainees who received PPH training at Peking University Third Hospital from March to July 2023. They were divided into two groups: the control group (<i>n</i> = 50) followed traditional simulation training methods, and the research group (<i>n</i> = 26) used a combination of CBL-PBL and scenario simulation. After the training, all participants completed a theoretical examination and questionnaire to assess their satisfaction with the program and self-assessment of clinical management skills in PPH. Statistical analysis was performed using unpaired t-tests and chi-square tests to compare the groups. The combination of CBL-PBL and scenario simulation was highly satisfactory compared to traditional simulation training, significantly enhancing self-assessed skills in clinical thinking (100% vs. 61.8%, <i>p</i> = .03), operant skills related to PPH (100% vs. 57.4%, <i>p</i> &lt; .01), relevant knowledge pertaining to PPH (100% vs. 58.7%, <i>p</i> &lt; .01), and management abilities (97.1% vs. 39%, <i>p</i> &lt; .01) among midwifery trainees in the research group, who also scored significantly higher on post-training assessments of PPH knowledge than control groups(91.7 ± 6.0 vs 76.0 ± 7.1, <i>p</i> &lt; .01). A majority of trainees expressed a preference for regular simulation exercises (98.7%) and detailed discussions on PPH cases (93.4%) in future training sessions. Combining CBL-PBL with simulation practice is a more effective teaching method for PPH management training in maternity staffs with a certain level of clinical experience, compared to traditional methods. Future studies should explore the implementation of regular PPH rescue skill training in real clinical settings to support these findings. Postpartum haemorrhage remains the leading cause of maternal mortality worldwide. It is crucial for all midwifery practitioners to receive comprehensive and proficient training in postpartum haemorrhage management techniques. Although simulation teaching is widely used in postpartum haemorrhage technical training, its effectiveness may be hindered by a limited range of scenarios and inflexible scripts, potentially compromising its ability to fully address training objectives. To overcome these limitations, we integrated case-based learning (CBL) rooted in the analysis of medical records to recreate real-life clinical scenarios with problem-based learning (PBL), which is characterised by independent study, group discussions, and collaborative problem-solving. Our study demonstrated that this combined CBL-PBL teaching methodology, along with simulation practice among maternity staffs with a certain level of clinical experience, was highly effective in enhancing self-assessment of skills including clinical thinking, operant skills related to postpartum haemorrhage, relevant knowledge pertaining to postpartum haemorrhage, and management abilities among midwifery trainees. However, it should be noted that there are several limitations in this study including an unrandomized quasi-experimental design and a greater emphasis on vaginal delivery practices. Additionally, the effectiveness of this approach in actual clinical practice has not been evaluated yet. Further research should focus on incorporating regular training on postpartum haemorrhage rescue skills and evaluating their efficacy in real clinical settings to ensure comprehensive preparedness among midwifery professionals for managing postpartum haemorrhage and other obstetric emergencies while reducing maternal mortality rates.