1. Louanne Friend, PhD; Catherine Skinner, MD The University of Alabama
The Effects of an Advanced Life Support Obstetrical Intra-professional Class on Participant Intra-professional Socialization and Readiness to Function in Intra-professional Teams
Blake DeWitt, MD
Louanne Friend, PhD; Catherine Skinner, MD
The University of Alabama
INTRODUCTION
CONCLUSIONS/SIGNIFICANCE
The results of the Jefferson Scale did not show statistical significance increase from pre to post testing. This could be due to small sample size or the fact that Jefferson scale addresses factors including nurse autonomy and physician dominance, items not addressed within the context of the ALSO course. The importance of teamwork question also did not reach significance during this study due to high pretest scores and small sample size. The ISVS did show significant improvement as well as the individuals overall confidence with managing obstetrics and its complications.
Overall, this study shows support for early collaborative learning experience for Interns and Labor and Delivery nurses in establishing a teamwork mindset. This significance held true not only with the group as a whole but also with the individual groups (nurses and interns). Furthermore, subjective measures such as, first hand testimonials, further support the statistical significance shown by the survey.
The Advanced Life Support Obstetrics (ALSO) course was invented in 1991 by two Wisconsin physicians.(1)
They chose to develop a course for training of physicians, registered nurses and to address the four major causes of morbidity and mortality of maternity.
The course was developed using the model of ATLS and ACLS, utilizing an intensive 2-day training followed by written and practical examination to demonstrate mastery of the content.
The course is open to physicians, residents, midwifes and nurses alike.
Currently the ALSO training is offered in over 62 countries and more than 50,000 health care professionals have attended the course.
The University of Alabama Family Medicine Residency has adopted this program as part of its orientation for incoming interns in order to lay the framework for Obstetrical care. This year Labor and Delivery nurses were invited to participate as a collaborative learning experience. All participants were placed in the same lectures, workshops and held to same standard on grading criteria regardless of training background.
RESULTS
FUTURE DIRECTIONS
Each year, new interns become part of the University of Alabama Family Medicine Residency and must develop both medical acumen and effective communication skills with patients and nurses in order to become effective physicians.
The hope of this study is to further promote collaboration of residents and nurses through annual ALSO co-training sessions.
Additionally, this could provide larger sample size to further demonstrate the importance of the co-training experiences.
METHODS
The study was conducted using a Qualitrics pre- and post-class survey surrounding a collaborative learning experience utilizing the ALSO curriculum.
Sixteen Family Medicine Interns, two ER Fellows and six labor and delivery nurses were asked to participate
Survey included:
Interprofessional Socialization and Valuing Scale (21 question version)
Jefferson Scale of Attitudes towards Physician-Nurse collaboration
Overall comfort with obstetrics and managing complications
Demographical questions
The results were then analyzed using paired sample t-tests.
REFERENCES
A paired-samples t-test was conducted to evaluate the impact of the ALSO class on teamwork among Labor and Delivery nurses and Family Medicine Interns. There was a statistically significant increase in the summed totals of the Interprofessional Socialization and Values Scale (ISVS) from the Pre-class survey (M=116.30, SD=15.87) to the Post-class survey (M=132.50, SD=11.56), t(19)= -6.45, p<.01 (two-tailed). The eta squared statistic (.68) indicated a large effect size.
A paired-samples t-test was used to analyze the Pre-class survey and Post-class survey summed totals of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. The increase from Pre- to Post- was not statistically significant with the Pre-class survey (M=53.33, SD=3.55) to the Post-class survey (M=54.33, SD=3.24), t(23)= -2.03, p=.054 (two-tailed).
A paired-samples t­-test was used to analyze the Pre-class survey and Post-class survey ratings of comfort in regards to various training outcomes. Overall, participants felt more comfortable in being actively involved in managing normal vaginal delivery, managing postpartum hemorrhage, and in managing shoulder dystocia following the ALSO class. Participants rated the importance of teamwork highly on both the pre-class survey (M=9.73, SD=.77) and the post-class survey (M=9.86, SD=.47), and thus there was no significant increase.
1. Beasley, J. W., Damos, J. R., Roberts, R. G., & Nesbitt, T. S. (1994). The advanced life support in obstetrics course: a national program to enhance obstetric emergency skills and to support maternity care practice. Archives of family medicine, 3(12), 1037.
ACKNOWLEDGEMENTS
Thank you to DCH Regional Medical Center for funding the Labor and Delivery nurses tuition for the ALSO course.
Thank you to Tuscaloosa Family Medicine Residency for funding ALSO course for Interns and allowing us to conduct our survey.
Thank you to Kathryn Kouchi, graduate student in clinical psychology for running the statistics.