The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Dec 2013
ReviewEmergency obstetric simulation training: how do we know where we are going, if we don't know where we have been?
Obstetric emergencies contribute significantly to maternal morbidity and mortality. Current training in the management of obstetric emergencies in Australia and internationally focusses on utilising a multidisciplinary simulation-based model. Arguments for and against this type of training exist, using both economic and clinical reasoning. ⋯ Evidence exists for a positive impact of training in obstetric emergencies, although the majority of the available evidence applies to evaluation at the level of participants' confidence, knowledge or skills rather than at the level of impact on clinical outcomes. The model of simulation-based training is an appropriate one for the Australian setting and should be further utilised in rural and remote settings.
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Aust N Z J Obstet Gynaecol · Dec 2013
Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an Advanced Life Support in Obstetrics course in Australia.
The Advanced Life Support in Obstetrics (ALSO) course is an internationally recognised interprofessional course to support health professionals to develop and maintain the knowledge and skills to manage obstetric emergencies. ⋯ Completion of the Australian ALSO course in Australia has a positive effect on the confidence and perceived knowledge of doctors and midwives to manage obstetric emergencies. However, there needs to be some means of reinforcing the effects of the course for longer term maintenance of knowledge and confidence.
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Aust N Z J Obstet Gynaecol · Oct 2013
The introduction and the validation of a surgical encounter template to facilitate surgical coaching of gynaecologists at a metropolitan tertiary obstetrics and gynaecology hospital.
At a metropolitan tertiary obstetrics and gynaecology hospital some gynaecologists identified a need for surgical coaching. Full-time specialists in a teaching hospital are expected to teach surgery whilst having limited access to improving their own surgical skills. Over time, this resulted in some degree of technical deskilling. This in turn led to a loss of confidence in their technical ability to perform complex procedures. The trainee was potentially taught surgery by gynaecologists who were not confident in some aspects of their own surgical skill. ⋯ A structured surgical coaching template used in a surgical coaching program facilitated short-term self-perceived improvement in surgical skill and confidence. Participants also expressed an intention to introduce a more structured approach in their teaching. The structured programme using the encounter template may have a potential role in remediating a surgeon identified as an outlier by a credentialing body.
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Aust N Z J Obstet Gynaecol · Aug 2013
Prospective audit of vitamin D levels of women presenting for their first antenatal visit at a tertiary centre.
Vitamin D deficiency in pregnancy is associated with adverse events such as pre-eclampsia, primary caesarean section and vitamin D deficiency of the newborn. Vitamin D screening in pregnancy is not universal. ⋯ Based on current normal ranges for vitamin D, risk-based screening criteria for vitamin D deficiency in pregnancy fails to detect over half of vitamin D deficient women at our institution. Current South Australian guidelines should be amended in favour of universal screening of vitamin D for all pregnant patients at their booking visit.
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Aust N Z J Obstet Gynaecol · Aug 2013
Prevalence and determinants of complementary and alternative medicine use during pregnancy: results from a nationally representative sample of Australian pregnant women.
Pregnant women have been identified as high users of complementary and alternative medicine (CAM). However, no research to date has provided a detailed analysis of the prevalence and determinants of CAM consumption amongst pregnant women. ⋯ Most pregnant women are utilising CAM products and/or services as part of their maternity care and obstetricians, general practitioners and midwives need to enquire with women in their care about possible CAM use to help promote safe, effective coordinated maternity care.