Video analysis of real‐life shoulder dystocia to assess technical and non‐technical performance
Loading...
Author (Corporation)
Publication date
2024
Typ of student thesis
Course of study
Collections
Type
01A - Journal article
Editors
Editor (Corporation)
Supervisor
Parent work
Acta Obstetricia et Gynecologica Scandinavica
Special issue
DOI of the original publication
Link
Series
Series number
Volume
Issue / Number
Pages / Duration
Patent number
Publisher / Publishing institution
Wiley
Place of publication / Event location
Hoboken
Edition
Version
Programming language
Assignee
Practice partner / Client
Abstract
Introduction
Managing obstetric shoulder dystocia requires swift action using correct maneuvers. However, knowledge of obstetric teams' performance during management of real‐life shoulder dystocia is limited, and the impact of non‐technical skills has not been adequately evaluated. We aimed to analyze videos of teams managing real‐life shoulder dystocia to identify clinical challenges associated with correct management and particular non‐technical skills correlated with high technical performance.
Material and Methods
We included 17 videos depicting teams managing shoulder dystocia in two Danish delivery wards, where deliveries were initially handled by midwives, and consultants were available for complications. Delivery rooms contained two or three cameras activated by Bluetooth upon obstetrician entry. Videos were captured 5 min before and after activation. Two obstetricians assessed the videos; technical performances were scored as low (0–59), average (60–84), or high (85–100). Two other assessors evaluated non‐technical skills using the Global Assessment of Team Performance checklist, scoring 6 (poor) to 30 (excellent). We used a spline regression model to explore associations between these two score sets. Inter‐rater agreement was assessed using interclass correlation coefficients.
Results
Interclass correlation coefficients were 0.71 (95% confidence interval 0.23–0.89) and 0.82 (95% confidence interval 0.52–0.94) for clinical and non‐technical performances, respectively. Two teams had low technical performance scores; four teams achieved high scores. Teams adhered well to guidelines, demonstrating limited head traction, McRoberts maneuver, and internal rotation maneuvers. Several clinical skills posed challenges, notably recognizing shoulder impaction, applying suprapubic pressure, and discouraging women from pushing.
Two non‐technical skills were associated with high technical performance: effective patient communication, with teams calming the mother and guiding her collaboration during internal rotational maneuvers, and situation awareness, where teams promptly mobilized all essential personnel (senior midwife, consultant, pediatric team). Team communication, stress management, and task management skills were not associated with high technical performance.
Conclusions
Videos capturing teams managing real‐life shoulder dystocia are an effective tool to reveal challenges with certain technical and non‐technical skills. Teams with high technical performance are associated with effective patient communication and situational awareness. Future training should include technical skills and non‐technical skills, patient communication, and situation awareness.
Keywords
Subject (DDC)
Event
Exhibition start date
Exhibition end date
Conference start date
Conference end date
Date of the last check
ISBN
ISSN
0001-6349
1600-0412
1600-0412
Language
English
Created during FHNW affiliation
Yes
Strategic action fields FHNW
Future Health
Publication status
Published
Review
Peer review of the complete publication
Open access category
Gold
Citation
Roed Hjorth‐Hansen, K., Rosvig, L., Hvidman, L., Kierkegaard, O., Uldbjerg, N., Manser, T., & Brogaard, L. (2024). Video analysis of real‐life shoulder dystocia to assess technical and non‐technical performance. Acta Obstetricia et Gynecologica Scandinavica. https://doi.org/10.1111/aogs.14900