(22) High-Fidelity Simulations for First Responders: Addressing Health Equity Through Enhanced Prehospital Obstetric and Neonatal Care.

Abstract:

Background: Prehospital obstetrical or neonatal (OB/Neo) calls to emergency medical services (EMS) are more likely among patients of lower socioeconomic status and to result in an OB/Neo emergency. Paramedicine faculty have expressed the need for paramedic learners (PML) to increase confidence in these skills to promote health equity and improve maternal and neonatal health outcomes. Limited literature in use of simulation-based experiences (SBE) in prehospital settings have demonstrated improved confidence among EMS and the Zone of Simulation framework , indicates these scenarios fall into the high acuity-low occurrence quadrant, suggesting SBE may be advantageous over instruction.

Purpose: A team of nursing and paramedicine faculty worked with simulation staff to design OB/Neo emergency SBEs for PMLs.

Methods: PMLs learners (n=13) participated in didactic on normal vaginal delivery, breech presentation, neonatal resuscitation, and handoff communication before rotating through four OB/Neo emergency SBE stations: application of OB/Neo skills with one normal vaginal simulation, two complex deliveries, and one combined OB/Neo scenario, followed by a group debrief. Confidence was assessed using nine item Likert scale and two open-ended questions on a computer-based survey.

Results: Learners were surveyed two months following completion of SBE. All stated they had some experience with OB/Neo emergencies prior to the SBE, but endorsed SBE as helpful to their professional practice and improved skill confidence. Debriefing was also emphasized as a helpful simulation tool, two general themes emerged: importance of controlling the environment and therapeutic communication with OB/Neo patients.

Conclusions: High-fidelity SBE improves confidence for learners in OB/Neo emergency situations.

Please include a short summary of your presentation that highlights why an attendee would want to view your poster.: Simulation-based education is an important tool for developing confidence in emergency medical services (EMS) to manage emergencies. Disadvantaged populations are more likely to use EMS when encountering an obstetric emergency. An interprofessional approach to simulation is necessary to understand specialized care priorities of obstetric and neonatal clients while upholding EMS scope of practice to promote positive patient outcomes.