The limited use of instructional design guidelines in healthcare simulation scenarios: an expert appraisal.

Background: Systematic reviews on simulation training effectiveness have pointed to the need to adhere to evidence-based instructional design (ID) guidelines. ID guidelines derive from sound cognitive theories and aim to optimize complex learning (integration of knowledge, skills, and attitudes) and learning transfer (application of acquired knowledge and skills in the workplace). The purpose of this study was to explore adherence to ID guidelines in simulation training programs for dealing with postpartum hemorrhage (PPH), a high-risk situation and the leading cause of maternal mortality worldwide.

Effects of an instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study.

To compare postpartum hemorrhage (PPH) patient outcomes before and after an instructional design based PPH simulation attended by obstetrics and gynecology (OBGYN) residents. This uncontrolled before-and-after study was conducted in Recife, Brazil including all 1388 women delivering from June to August 2012 and all 1357 delivering from June to August 2013. The 36 OBGYN residents were divided into13 teams of two or three participants and were trained through ID based PPH simulation training with the following eight steps: (1) prior knowledge activation, (2) video demonstration, (3) dual-coding PPH protocol discussion-an image association during the training, (4) training scenario # 1, (5) debriefing, (6) training scenario # 2 with immediate feedback, (7) training scenario # 3, and (8) debriefing with self-assessment.

Self-perceived long-term transfer of learning after postpartum hemorrhage simulation training.

Objective: To explore long-term transfer (application of acquired knowledge and skills on the job) after postpartum hemorrhage simulation training based on either instructional design (ID) principles or conventional best practice.

Methods: In this qualitative study, semi-structured interviews with obstetrics and gynecology healthcare practitioners were conducted between August 7 and September 26, 2015, in Recife, Brazil. The participants were randomly selected from each of two postpartum hemorrhage simulations attended 2 years earlier (one ID and one conventional best practice).

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

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

Methods: 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.

[Amniotic fluid volume and maternal outcomes in women with preterm premature rupture of membranes].

Purpose: To describe the potential influence of amniotic fluid on the maternal outcome of preterm premature rupture of membranes (PROM).

Methods: An observational, retrospective cohort study was conducted between December 2012 and January 2008 on 86 pregnant women with preterm PROM and a gestational age (GA) of 24 to 35 weeks. The amniotic fluid index (AFI) was used to measure aminiotic fluid volume.

Uterine artery Doppler in the third trimester of pregnancy and postnatal outcome of patients with severe preeclampsia.

Objectives: To assess uterine artery Doppler velocimetry performed in the third trimester of pregnancy in women with severe preeclampsia as a predictor of adverse postpartum outcome.

Methods: A cohort study including 154 women, conducted in a teaching hospital in Recife, Brazil. Uterine artery Doppler was performed at admission to hospital and postpartum outcome was evaluated.