Interprofessional Simulation Based Training for Obstetric and Neonatal Emergencies: A Systematic Review

BACKGROUND Interprofessional (IP) simulation-based training (SBT) is a very important tool for enhancing multidisciplinary teamwork when managing obstetric and neonatal emergencies and emergencies in any medical speciality. While current evidence supports the role of IP SBT in improving practitioner collaboration and patient outcomes, systematic reviews to date have focused on SBT within individual specialties. We aimed to systematically review the prevalence and effectiveness of combined IP SBT in the management of obstetric and neonatal emergencies globally. METHODS We conducted a systematic search of several databases (PubMed, EMBASE, CINAHL, MEDLINE) for relevant articles. Our search focused on looking at combined obstetric and neonatal IP SBT in a clinical education setting from inception to October 2024. The Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-1) tool was used to perform a risk of bias assessment for quantitative studies. The Joanna Briggs Institute (JBI) checklist was used risk of bias assessment of qualitative studies. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool to assess the certainty of available evidence. RESULTS We found 6374 articles in our initial systematic search. Following screening, 40 studies met the inclusion criteria, involving healthcare professionals from 18 countries. The type of SBT programs varied, with the Obstetrics and Neonatal Emergency Simulation (ONE-Sim) program being the most common, reported in 7 studies. Other programs included Simulation and Team Training for Obstetric and Neonatal Emergencies (PRONTO), Enhancing Training and Technology for Mothers and Babies in Africa (ETATMBA) and Practical Obstetric Multi-Professional Training (PROMPT). The simulation programs usually consisted of several obstetric and neonatal emergency simulation scenarios which were followed by participant debrief. The included studies reflected on the simulation environment, practitioner reported outcomes such as clinician skills, leadership, knowledge, confidence, interprofessional teamwork, clinical and organisational outcomes. Using the GRADE approach there was an overall moderate certainty of evidence for the effectiveness of SBT in obstetric and neonatal emergencies. CONCLUSION This review supports the need for increased availability and provision of IP SBT training across the globe. Despite current studies showing benefit in enhancing clinician skills, patient outcomes and organisational performance, the evidence on SBT programs for managing obstetric and neonatal emergencies remains limited and requires further research and implementation.