Hybrid simulated patient methodology: managing maternal deterioration

Concerns have been raised about midwives’ ‘failure to rescue’ and their ability to manage maternal deterioration, with questions over clinical skills and knowledge
and the implications for morbidity and mortality. With these issues in mind, we worked with simulated patients (SPs) to examine student midwives’ ability to assess and manage maternal deterioration using measures of knowledge, skill, situation awareness and decision-making. SPs wearing ‘birthing suits’ simulated women in maternal deterioration. In total 35 students were assessed. Knowledge scores averaged 75% (range 46 – 91%) but skill performance was low, averaging 54% (range 39 – 70%) and with notable performance decrements as the women’s condition deteriorated. Students’ evaluations indicated significant benefits of the programme and the high psychological fidelity of the scenarios and SPs.