BACKGROUND:
Shoulder dystocia is a serious childbirth-related emergency.

OBJECTIVES:
This was a randomised-controlled-trial aiming to quantify the effect of a leadership and teamwork training on the improvement of skills in managing shoulder dystocia.

METHODS:
Final-year Midwifery students were invited to participate in a one-day workshop. They were randomised to either group A (shoulder dystocia simulation-training + intervention), or group B (only shoulder dystocia simulation-training). The simulation-training and assessments were performed with a high-fidelity (PROMPT) birthing simulator. The intervention consisted of a two-hour leadership and teamwork experiential learning module. All students had a 30-minute initial pre-training assessment, a 30-minute theoretical and hands-on training, and a 30-minute post-training assessment. In the workshop, the outcomes assessed were the proportion of successful simulated births, the performance of manoeuvres to manage shoulder dystocia, the head-to-body birth time, the quality of communication, the self-reported confidence levels, the levels of teamwork and leadership skills. Group A students received the intervention after their theoretical and hands-on training and before the final post-training assessment at the end of the workshop. Pre-training and post-training values for the predetermined outcomes were compared.

RESULTS:
There were 51 students recruited in total with mean age of 21.9 years (SD=3.1), of which 25 received the intervention and 26 were controls. Both groups demonstrated similar low pre-training values regarding the proportion of successful deliveries, manoeuvres’ score, confidence levels, communication, teamwork and leadership skills. Both groups had similar high post-training values of successful deliveries (>92%), manoeuvres’ score, confidence levels. Those receiving the intervention when compared to controls demonstrated a statistical trend of higher communication (4.4 vs 3.1;p=0.10), teamwork (3.1 vs 2.1;p=0.10) and leadership skills (3.8 vs 2.6;p=0.08) at the end of the workshop.

CONCLUSIONS:
This study supports the inclusion of a teamwork and leadership training in shoulder dystocia management.

KEY MESSAGE:
Teamwork and leadership skills training should be included in shoulder dystocia simulation-training. Education - competency development 3 (including three-minute presentation competition)