Video analysis of real‐life shoulder dystocia to assess technical and non‐technical performance

dc.contributor.authorRoed Hjorth‐Hansen, Kristiane
dc.contributor.authorRosvig, Lena
dc.contributor.authorHvidman, Lone
dc.contributor.authorKierkegaard, Ole
dc.contributor.authorUldbjerg, Niels
dc.contributor.authorManser, Tanja
dc.contributor.authorBrogaard, Lise
dc.date.accessioned2024-09-20T16:04:48Z
dc.date.available2024-09-20T16:04:48Z
dc.date.issued2024
dc.description.abstractIntroduction 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.
dc.identifier.doi10.1111/aogs.14900
dc.identifier.issn0001-6349
dc.identifier.issn1600-0412
dc.identifier.urihttps://irf.fhnw.ch/handle/11654/47301
dc.identifier.urihttps://doi.org/10.26041/fhnw-10265
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofActa Obstetricia et Gynecologica Scandinavica
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.spatialHoboken
dc.subject.ddc610 - Medizin und Gesundheit
dc.titleVideo analysis of real‐life shoulder dystocia to assess technical and non‐technical performance
dc.type01A - Beitrag in wissenschaftlicher Zeitschrift
dspace.entity.typePublication
fhnw.InventedHereYes
fhnw.ReviewTypeAnonymous ex ante peer review of a complete publication
fhnw.affiliation.hochschuleHochschule für Angewandte Psychologiede_CH
fhnw.affiliation.institutDirektion APSde_CH
fhnw.openAccessCategoryGold
fhnw.publicationStatePublished
relation.isAuthorOfPublicationf72d4ebf-e8f9-41e6-a75c-151334fdd206
relation.isAuthorOfPublication.latestForDiscoveryf72d4ebf-e8f9-41e6-a75c-151334fdd206
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