Abstract
Postpartum hemorrhage (PPH) remains a global challenge, affecting thirteen million women each year. In addition, PPH is a leading cause of maternal mortality in Asia and Africa. In the U.S.A., care of critically ill patients is often practiced using mannequin-based simulation. Mannequin-based simulation presents challenges in global health, particularly in low- or middle-income countries. We developed a novel multiplayer screen-based simulation in a virtual world enabling the practice of team coordination with PPH. We used this simulation with learners in Mulago, Uganda. We hypothesized that a multiplayer screen-based simulation experience would increase learner confidence in their ability to manage PPH. The study design was a simple pre- and a post-intervention survey. Forty-eight interprofessional subjects participated in one of nine 1-h simulation sessions using the PPH software. A fifteen-question self-assessment administered before and after the intervention was designed to probe the areas of learning as defined by Bloom and Krathwohl: affective, cognitive, and psychomotor. Combined confidence scores increased significantly overall following the simulation experience and individually in each of the three categories of Bloom's Taxonomy: affective, cognitive, and psychomotor. We provide preliminary evidence that multiplayer screen-based simulation represents a scalable, distributable form of learning that may be used effectively in global health education and training. Interestingly, despite our intervention being screen-based, our subjects showed improved confidence in their ability to perform psychomotor tasks. Although there is precedent for mental rehearsal improving performance, further research is needed to understand this finding.
Highlights
Postpartum hemorrhage (PPH) remains a global challenge, affecting thirteen million women each year
In collaboration with a local government contractor (Applied Research Associates, Cary, NC, USA), we developed a multiplayer screen-based simulation that enables the practice of teamwork and communication in the setting of postpartum hemorrhage (PPH)
46% of learners had participated in a mannequin-based simulation, only 15% had experienced a computer-based simulation
Summary
Postpartum hemorrhage (PPH) remains a global challenge, affecting thirteen million women each year. PPH is a leading cause of maternal mortality in Asia and Africa. Mannequin-based simulation presents challenges in global health, in low- or middle-income countries. We developed a novel multiplayer screen-based simulation in a virtual world enabling the practice of team coordination with PPH. We used this simulation with learners in Mulago, Uganda. We hypothesized that a multiplayer screen-based simulation experience would increase learner confidence in their ability to manage PPH. PPH remains a global challenge, affecting thirteen million women each year [2] and is a leading cause of maternal mortality in Asia and Africa [3]. Teamwork and communication training is a critical component in the management of any life-threatening event
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