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Int J Gynaecol Obstet. 2017 Apr;137(1):99-105. doi: 10.1002/ijgo.12084. Epub 2017 Jan 16.

The use of instructional design guidelines to increase effectiveness of postpartum hemorrhage simulation training.

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Faculdade Pernambucana de Saúde and Centro de Atenção à Mulher, Instituto de Medicina Integral Prof. Fernando Figueira, Centro de Atenção à Mulher, Recife, Brazil.
School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.



To compare learning outcomes of postpartum hemorrhage simulation training based on either instructional design guidelines or best practice.


A pretest-post-test non-equivalent groups study was conducted among obstetrics and gynecology residents in Recife, Brazil, from June 8 to August 30, 2013. The instructional design group included 13 teams, whereas the best practice group included seven teams. A standardized task checklist was used for scenario analysis and the proportion of correctly executed tasks compared (post-test minus pretest).


The instructional design group scored higher than the best practice group for total number of tasks completed (median difference 0.46 vs 0.17; P<0.001; effect size [r]=0.72). Similar results were observed for communication (median difference 0.56 vs 0.22; P=0.004; r=0.58), laboratory evaluation (median difference 0.83 vs 0.00; P<0.001; r=0.76), and mechanical management (median difference 0.25 vs -0.15; P=0.048; r=0.39). Speed of learning was also increased. The median differences were 0.20 for the instructional design group compared with 0.05 for the best practice group at 60 seconds (P=0.015; r=0.49), and 0.49 versus 0.26 (P=0.001; r=0.65) at 360 seconds.


The use of simulation training for postpartum hemorrhage that was based on instructional design guidelines yielded better learning outcomes than did training based on best practice.


Education; Instructional design; Postpartum hemorrhage; Simulation training; Situational awareness; Training

[Indexed for MEDLINE]

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