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Interdisciplinary Simulation-Based Training to Improve Delivery Room Communication

Dadiz, Rita DO; Weinschreider, Joanne RN, MS; Schriefer, Jan MSN, MBA, DrPH; Arnold, Christine RN, MS; Greves, Cole D. MD; Crosby, Erin C. MD; Wang, Hongyue PhD; Pressman, Eva K. MD; Guillet, Ronnie MD, PhD

doi: 10.1097/SIH.0b013e31829543a3
Empirical Investigations

Introduction Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams.

Methods Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008–2011 (Y1–Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance.

Results At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05).

Conclusions Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.

From the Divisions of Neonatology (R.D., R.G.) and Hospital Medicine (J.S.), Department of Pediatrics, and Department of Obstetrics and Gynecology (J.W., C.A., C.D.G., E.C.C., E.K.P.), and Department of Biostatistics and Computational Biology (H.W.), University of Rochester Medical Center, Rochester, NY.

Reprints: Rita Dadiz, DO, Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Ave, Box 651, Rochester, NY 14642 (e-mail:

The authors declare no conflict of interest.

Funding for this study was provided in part by the Dean’s Teaching Fellowship Program from the University of Rochester School of Medicine and Dentistry, the Strong Children’s Research Center from the University of Rochester Medical Center, and the Health Resources and Services Administration from the Department of Health and Human Services (grant number T21MC18129-01-00).

© 2013 Society for Simulation in Healthcare