Dilys Walker | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

Background: In 2009, PRONTO International began training provider teams using in-situ highly-realistic simulation and team training to improve emergency obstetric and neonatal care (EmONC) in resource-limited settings. PRONTO collaborated with CARE India in 2014 to pilot the model with an initial training for nurse-midwife mentors, in conjunction with a larger quality improvement initiative.

Methods:  PRONTO International has conducted two rounds of Simulator Facilitator Trainings with nurse midwife mentors and doctors in Bihar. Training focused on improving mentor EMONC knowledge and skills through simulation, and introducing simulation facilitation and teamwork training, to strengthen their existing in-situ clinic mentoring program. All nurse midwives and doctors participating in the CARE India mentoring program were eligible. We measured change in overall and topic-specific knowledge.

Results: Two 5-day PRONTO training sessions were held. To date, 82 mentors have been trained. Overall knowledge across both mentor trainings improved 27.1%. Obstetric hemorrhage scores improved 25.2%, teamwork and communication scores improved 26.0%, and pre-eclampsia/eclampsia scores improved 18.3%. Neonatal resuscitation and simulation facilitation scores were measured at the January 2015 training, and improved 15.2% and 18.3% respectively. All results were statistically significant (p <0.001). The pilot training in 2014, informed the Bihar-specific adaptations needed to develop a comprehensive and flexible mentoring curriculum and mentor trainings that a team of mobile nurse mentors will use as they roll the program in the 376 facilities from 2015-2017.

Conclusion: PRONTO simulation facilitator training is an effective model for increasing mentor EmONC knowledge and for introducing simulation skills for mentors. Based on these results, the presenter will discuss the importance, challenges, and benefits of introducing a validated simulation training strategy that takes into account context specific conditions.