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. 2022 Jun 24;22(1):513.
doi: 10.1186/s12884-022-04845-2.

Mixed methods evaluation of simulation-based training for postpartum hemorrhage management in Guatemala

Pooja S Parameshwar  1 , Katherine Bianco  2 , Elizabeth B Sherwin  2 , Pamela K Meza  1 , Alisha Tolani  2 , Paige Bates  2 , Lillian Sie  2 , Andrea Sofía López Enríquez  3 , Diana E Sanchez  1 , Edgar R Herrarte  3 , Kay Daniels  4
Affiliations

Mixed methods evaluation of simulation-based training for postpartum hemorrhage management in Guatemala

Pooja S Parameshwar et al. BMC Pregnancy Childbirth. .

Abstract

Background: To assess if simulation-based training (SBT) of B-Lynch suture and uterine balloon tamponade (UBT) for the management of postpartum hemorrhage (PPH) impacted provider attitudes, practice patterns, and patient management in Guatemala, using a mixed-methods approach.

Methods: We conducted an in-country SBT course on the management of PPH in a governmental teaching hospital in Guatemala City, Guatemala. Participants were OB/GYN providers (n = 39) who had or had not received SBT before. Surveys and qualitative interviews evaluated provider knowledge and experiences with B-Lynch and UBT to treat PPH.

Results: Multiple-choice surveys indicated that providers who received SBT were more comfortable performing and teaching B-Lynch compared to those who did not (p = 0.003 and 0.005). Qualitative interviews revealed increased provider comfort with B-Lynch compared to UBT and identified multiple barriers to uterine balloon tamponade implementation.

Conclusions: Simulation-based training had a stronger impact on provider comfort with B-Lynch compared to uterine balloon tamponade. Qualitative interviews provided insight into the challenges that hinder uptake of uterine balloon tamponade, namely resource limitations and decision-making hierarchies. Capturing data through a mixed-methods approach allowed for more comprehensive program evaluation.

Keywords: Global health; Maternal mortality; Medical education; Obstetrics; Simulation-based training.

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Conflict of interest statement

The authors declare that they have no competing interests.

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