Identification of Clinician Training Techniques as an Implementation Strategy to Improve Maternal Health: A Scoping Review

Training is a key implementation strategy used in healthcare settings. This study aimed to identify a range of clinician training techniques that facilitate guideline implementation, promote clinician behavior change, optimize clinical outcomes, and address implicit biases to promote high-quality maternal and child health (MCH) care. A scoping review was conducted within PubMed, CINAHL, PsycInfo, and Cochrane databases using iterative searches related to (provider OR clinician) AND (education OR training). A total of 152 articles met the inclusion/exclusion criteria. The training involved multiple clinician types (e.g., physicians, nurses) and was predominantly implemented in hospitals (63%). Topics focused on maternal/fetal morbidity/mortality (26%), teamwork and communication (14%), and screening, assessment, and testing (12%). Common techniques included didactic (65%), simulation (39%), hands-on (e.g., scenario, role play) (28%), and discussion (27%). Under half (42%) of the reported training was based on guidelines or evidence-based practices. A minority of articles reported evaluating change in clinician knowledge (39%), confidence (37%), or clinical outcomes (31%). A secondary review identified 22 articles related to implicit bias training, which used other reflective approaches (e.g., implicit bias tests, role play, and patient observations). Although many training techniques were identified, future research is needed to ascertain the most effective training techniques, ultimately improving patient-centered care and outcomes.

[1]  E. Howell,et al.  Intertwined disparities: Applying the maternal-infant dyad lens to advance perinatal health equity. , 2021, Seminars in perinatology.

[2]  N. Asdigian,et al.  Making It Stick: Use of Active Learning Strategies in Continuing Medical Education Running Head: Active Learning Strategies in Continuing Medical Education , 2020 .

[3]  Bani Saluja,et al.  How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States. , 2020, Journal of women's health.

[4]  Josephine Enciso,et al.  Teaching culturally competent healthcare in neonatal-perinatal medicine. , 2020, Seminars in perinatology.

[5]  H. Hsu,et al.  Effects of a cultural competence education programme on clinical nurses: A randomised controlled trial. , 2020, Nurse education today.

[6]  Alannah L Cooper,et al.  Improving the Clinical Skills and Knowledge of Midwives and Nurses Caring for Late Preterm Neonates. , 2019, Journal of continuing education in nursing.

[7]  Joanne Goldbort,et al.  A Proactive Approach to Quantification of Blood Loss in the Perinatal Setting. , 2019, Nursing for women's health.

[8]  R. Vinci,et al.  Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees , 2019, MedEdPORTAL : the journal of teaching and learning resources.

[9]  Margot Kaplan-Sanoff,et al.  "LET UP": A Systematic Approach to Responding to Cultural Bias in Health Care. , 2019 .

[10]  C. Klima,et al.  Reducing Barriers That Hinder Obstetric Providers From Addressing Perinatal Depression: A Provider Education Module , 2019, Journal of Doctoral Nursing Practice.

[11]  Nicole L Murn Mothering the Mother: An Educational Program for Nurse-Provided Continuous Labor Support , 2019, The Journal of Perinatal Education.

[12]  S. Gisin,et al.  Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program , 2019, Journal of perinatal medicine.

[13]  Tanesha L. Stokes,et al.  Preparing Perinatal Nurses for Obstetric OR Emergencies by Using Simulations. , 2019, AORN journal.

[14]  Sharon L Holley,et al.  Implementation of a Perinatal Depression Care Bundle in a Nurse-Managed Midwifery Practice. , 2019, Nursing for women's health.

[15]  B. Hayward,et al.  Evaluation of an embryology and genetic testing patient counseling education intervention for reproductive endocrinology nurses. , 2019, Fertility and sterility.

[16]  C. Begley,et al.  Shared decision‐making in maternity care: Acknowledging and overcoming epistemic defeaters , 2019, Journal of evaluation in clinical practice.

[17]  J. Steiner,et al.  Implementation of Recommendations for Long-Acting Contraception Among Women Aged 13 to 18 Years in Primary Care. , 2019, Academic pediatrics.

[18]  J. Coleman,et al.  Improving Provider Readiness for Intimate Partner Violence Screening. , 2019, Worldviews on evidence-based nursing.

[19]  E. Carey,et al.  Gynecologic oncology providers endorse practice-changing impact of communication skills training. , 2019, Gynecologic oncology.

[20]  Jill Chamberlain,et al.  Evaluation of an education session using standardized patients and role play during perinatal bereavement , 2019, Journal of Neonatal Nursing.

[21]  C. Gwede,et al.  Impact of a web‐based reproductive health training program: ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare) , 2019, Psycho-oncology.

[22]  C. Hayes,et al.  Evaluating the contribution of interdisciplinary obstetrics skills and drills emergency training , 2019, British Journal of Midwifery.

[23]  A. Gemmill,et al.  Trends in pregnancy‐associated mortality involving opioids in the United States, 2007–2016 , 2019, American journal of obstetrics and gynecology.

[24]  S. Nelson,et al.  The Impact of Health Equity Coaching on Patient’s Perceptions of Cultural Competency and Communication in a Pediatric Emergency Department: An Intervention Design , 2018, Journal of patient experience.

[25]  B. Herbig,et al.  A training intervention for home care nurses in cross-cultural communication: an evaluation study of changes in attitudes, knowledge, and behavior. , 2019, Journal of advanced nursing.

[26]  L. Hunter,et al.  Developing and evaluating an online learning tool to improve midwives' accuracy of visual estimation of blood loss during waterbirth: An experimental study. , 2019, Midwifery.

[27]  J. D. de Leeuw,et al.  Implementation of a perineal support programme for reduction of the incidence of obstetric anal sphincter injuries and the effect of non-compliance. , 2018, European journal of obstetrics, gynecology, and reproductive biology.

[28]  Ryan Macdonald,et al.  Improving Emergency Health Care Workers' Knowledge, Competency, and Attitudes Toward Lesbian, Gay, Bisexual, and Transgender Patients Through Interdisciplinary Cultural Competency Training , 2018, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[29]  P. Butow,et al.  Evaluation of an online communication skills training programme for oncology nurses working with patients from minority backgrounds , 2018, Supportive Care in Cancer.

[30]  K. New,et al.  Supporting healthy weight gain and management in pregnancy: Does a mandatory training education session improve knowledge and confidence of midwives? , 2018, Midwifery.

[31]  M. Blomberg,et al.  Improved clinical management but not patient outcome in women with postpartum haemorrhage—An observational study of practical obstetric team training , 2018, PloS one.

[32]  S. Ayers,et al.  A postgraduate Optimum Birth module to increase midwives' readiness to work in midwifery-led settings: A mixed-methods evaluation. , 2018, Birth.

[33]  B. Wilson,et al.  Perceptions of Safety Improvement Among Clinicians Before and After Participation in a Multistate Postpartum Hemorrhage Project , 2018, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[34]  S. Goodman,et al.  Training in aspiration abortion care: An observational cohort study of achieving procedural competence. , 2018, International journal of nursing studies.

[35]  K. Holt,et al.  Evaluation of a Training for Health and Social Service Providers on Abortion Referral-Making , 2018, Maternal and child health journal.

[36]  L. Wallace,et al.  Educational videos for practitioners attending Baby Friendly Hospital Initiative workshops supporting breastfeeding positioning, attachment and hand expression skills: Effects on knowledge and confidence. , 2018, Nurse education in practice.

[37]  T. Callahan,et al.  Screening for postpartum anxiety: A quality improvement project to promote the screening of women suffering in silence. , 2018, Midwifery.

[38]  E. Howell Reducing Disparities in Severe Maternal Morbidity and Mortality , 2018, Clinical obstetrics and gynecology.

[39]  P. Wändell,et al.  Impact of an educational intervention for district nurses about preparedness to encounter women exposed to intimate partner violence , 2018, Scandinavian journal of caring sciences.

[40]  J. Steinauer,et al.  Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: a cluster randomized trial , 2018, American journal of obstetrics and gynecology.

[41]  Kathryn Fraser,et al.  Addressing Racism in Medical Education An Interactive Training Module. , 2018, Family medicine.

[42]  A. Caughey,et al.  Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle. , 2018, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[43]  D. Boyle,et al.  Improving Rural Nurse Practitioner Knowledge About Polycystic Ovary Syndrome Through Continuing Education. , 2018, Journal of Continuing Education in Nursing: Continuing Competence for the Future.

[44]  E. L. Miller,et al.  Training reproductive health providers to talk about intimate partner violence and reproductive coercion: an exploratory study , 2018, Health education research.

[45]  D. Nutbeam,et al.  Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia , 2018, BMC Health Services Research.

[46]  S. Ayers,et al.  A multi-method evaluation of interprofessional education for healthcare professionals caring for women during and after pregnancy , 2018, Journal of interprofessional care.

[47]  P. Andresen,et al.  Educating Nurses to Screen and Intervene for Intimate Partner Violence During Pregnancy. , 2018, Nursing for women's health.

[48]  S. Srinivas,et al.  Interdisciplinary Skills Review Program to Improve Team Responses During Postpartum Hemorrhage , 2017, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[49]  M. Puckett,et al.  Ovarian Cancer Knowledge in Women and Providers Following Education with Inside Knowledge Campaign Materials , 2017, Journal of Cancer Education.

[50]  N. Matoba,et al.  Racial disparity in infant mortality. , 2017, Seminars in perinatology.

[51]  J. Norrie,et al.  THISTLE: trial of hands-on Interprofessional simulation training for local emergencies: a research protocol for a stepped-wedge clustered randomised controlled trial , 2017, BMC Pregnancy and Childbirth.

[52]  D. Cheng,et al.  Implementing Trauma-Informed Partner Violence Assessment in Family Planning Clinics. , 2017, Journal of women's health.

[53]  L. Moroz,et al.  Strategies to reduce disparities in maternal morbidity and mortality: Patient and provider education. , 2017, Seminars in perinatology.

[54]  C. Griffiths,et al.  Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention , 2017, Sexually Transmitted Infections.

[55]  E. Fosse,et al.  Evaluation of an animated instructional video as a training tool for manual perineum support during vaginal delivery , 2017, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[56]  L. Chitty,et al.  Development and evaluation of training resources to prepare health professionals for counselling pregnant women about non-invasive prenatal testing for Down syndrome: a mixed methods study , 2017, BMC Pregnancy and Childbirth.

[57]  Naihua Duan,et al.  An Overview of Research and Evaluation Designs for Dissemination and Implementation. , 2017, Annual review of public health.

[58]  N. Barrowman,et al.  Effect of an Educational Presentation about Extremely Preterm Infants on Knowledge and Attitudes of Health Care Providers , 2017, American Journal of Perinatology.

[59]  Y. Kataoka,et al.  Simulation training program for midwives to manage postpartum hemorrhage: A randomized controlled trial. , 2017, Nurse education today.

[60]  M. Lazarovici,et al.  Evaluation of simparteam – a needs-orientated team training format for obstetrics and neonatology , 2017, Journal of perinatal medicine.

[61]  E. Drake,et al.  Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project. , 2017, Military medicine.

[62]  R. Windrim,et al.  Simulator Based Obstetric Ultrasound Training: A Prospective, Randomized Single-Blinded Study. , 2017, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[63]  A. Holm,et al.  Recognizing Privilege and Bias: An Interactive Exercise to Expand Health Care Providers' Personal Awareness. , 2017, Academic medicine : journal of the Association of American Medical Colleges.

[64]  L. Snell,et al.  Twelve tips for promoting learning during presentations in cross cultural settings , 2017, Medical teacher.

[65]  J. Bailit,et al.  A Statewide Progestogen Promotion Program in Ohio. , 2017, Obstetrics and gynecology.

[66]  S. Saha,et al.  Mindfulness practice: A promising approach to reducing the effects of clinician implicit bias on patients. , 2017, Patient education and counseling.

[67]  J. Swanson,et al.  Roadmap to a successful quality improvement project , 2017, Journal of Perinatology.

[68]  Lawrence Chu,et al.  Effect of Nurse-Led Review Plus Simulation on Obstetric/Perinatal Nurses' Self-Assessed Knowledge and Confidence. , 2016, Nursing for women's health.

[69]  Tia P. Andrighetti,et al.  Modification of Obstetric Emergency Simulation Scenarios for Realism in a Home‐Birth Setting , 2017, Journal of midwifery & women's health.

[70]  Sangeeta Pathak,et al.  Evaluation of training programme uptake in an attempt to reduce obstetric anal sphincter injuries: the SUPPORT programme , 2017, International Urogynecology Journal.

[71]  Patricia A. Wilson,et al.  Evaluation of an international educational programme for health care professionals on best practice in the management of a perinatal death: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE) , 2016, BMC Pregnancy and Childbirth.

[72]  C. Gwede,et al.  ENRICH: A promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients. , 2016, Patient education and counseling.

[73]  P. Bodenmann,et al.  Cultural competence and simulated patients , 2016, The clinical teacher.

[74]  R. Oza-Frank,et al.  The Ohio Gestational Diabetes Postpartum Care Learning Collaborative: Development of a Quality Improvement Initiative to Improve Systems of Care for Women , 2016, Maternal and Child Health Journal.

[75]  S. Haynes,et al.  Two Tailored Provider Curricula Promoting Healthy Weight in Lesbian and Bisexual Women. , 2016, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[76]  J. Silverman,et al.  A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial. , 2016, Contraception.

[77]  P. Murphy,et al.  Evaluation of an intervention designed to improve the management of difficult IUD insertions by advanced practice clinicians. , 2016, Contraception.

[78]  Maree Johnson,et al.  The evaluation of an oral health education program for midwives in Australia. , 2016, Women and birth : journal of the Australian College of Midwives.

[79]  T. Flanagan,et al.  Perinatal Obstetric Office Depression Screening and Treatment: Implementation in a Health Care System. , 2016, Obstetrics and gynecology.

[80]  N. Leyland,et al.  Decreasing Diagnostic Hysteroscopy Performed in the Operating Room: A Quality Improvement Initiative. , 2016, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[81]  Robin L. Jones,et al.  The state of Illinois obstetric hemorrhage project: pre-project and post-training examination scores , 2016, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[82]  D. Goffman,et al.  Breaking Bad News in obstetrics: a randomized trial of simulation followed by debriefing or lecture , 2016, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[83]  C. Rocca,et al.  Public Funding for Contraception, Provider Training, and Use of Highly Effective Contraceptives: A Cluster Randomized Trial. , 2016, American journal of public health.

[84]  L. Bryant,et al.  Tell it Right, Start it Right: An evaluation of training for health professionals about Down syndrome , 2016 .

[85]  C. East,et al.  Simulation based training in a publicly funded home birth programme in Australia: A qualitative study. , 2016, Women and birth : journal of the Australian College of Midwives.

[86]  M. Liebergall‐Wischnitzer,et al.  Pelvic floor muscle training for midwives and nurses: a knowledge transfer study , 2016 .

[87]  M. Aita,et al.  Educational Intervention for an Evidence-Based Nursing Practice of Skin-to-Skin Contact at Birth , 2016, The Journal of Perinatal Education.

[88]  C. Satterwhite,et al.  Multi-professional training for obstetric emergencies in a US hospital over a 7-year interval: an observational study , 2016, Journal of Perinatology.

[89]  L. Holmes,et al.  Cultural Competence in Pediatrics: Health Care Provider Knowledge, Awareness, and Skills , 2015, International journal of environmental research and public health.

[90]  C. Ringsted,et al.  Linking quality of care and training costs: cost‐effectiveness in health professions education , 2015, Medical education.

[91]  A. deFazio,et al.  New Approaches to Continuing Medical Education: a QStream (spaced education) Program for Research Translation in Ovarian Cancer , 2015, Journal of Cancer Education.

[92]  Tamera Coyne-Beasley,et al.  Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review. , 2015, American journal of public health.

[93]  Cara C. Lewis,et al.  Outcomes for implementation science: an enhanced systematic review of instruments using evidence-based rating criteria , 2015, Implementation Science.

[94]  D. Østergaard,et al.  Multidisciplinary team training reduces the decision‐to‐delivery interval for emergency Caesarean section , 2015, Acta anaesthesiologica Scandinavica.

[95]  J. Seng,et al.  Pilot for Nurse-Led, Interprofessional In-Service Training on Trauma-Informed Perinatal Care. , 2015, Journal of continuing education in nursing.

[96]  T. Cheng,et al.  Child Health Disparities: What Can a Clinician Do? , 2015, Pediatrics.

[97]  Meredith Scannell,et al.  Sexual Assault Simulation Course for Healthcare Providers: Enhancing Sexual Assault Education Using Simulation , 2015, Journal of forensic nursing.

[98]  Susanne Rosthøj,et al.  Simulation-based multiprofessional obstetric anaesthesia training conducted in situ versus off-site leads to similar individual and team outcomes: a randomised educational trial , 2015, BMJ Open.

[99]  J. Sørensen,et al.  Clarifying the learning experiences of healthcare professionals with in situ and off-site simulation-based medical education: a qualitative study , 2015, BMJ Open.

[100]  B. Woodring,et al.  Developing a Systematic Approach to Obstetric Emergencies. , 2015, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[101]  D. Grossman,et al.  Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial , 2015, Pediatrics.

[102]  A. Langer,et al.  Critical maternal health knowledge gaps in low- and middle-income countries for the post-2015 era , 2015, Reproductive Health.

[103]  P. Kulbok,et al.  Evaluating a Quality Improvement Program for Cervical Cancer Screening at an Urban Safety Net Clinic , 2015, Health promotion practice.

[104]  R. Edwards,et al.  Online Continuing Education for Expanding Clinicians’ Roles in Breastfeeding Support , 2015, Journal of human lactation : official journal of International Lactation Consultant Association.

[105]  S. Baird,et al.  REACT: An Interprofessional Education and Safety Program to Recognize and Manage the Compromised Obstetric Patient , 2015, The Journal of perinatal & neonatal nursing.

[106]  J. Guise,et al.  Impact of simulation and team training on postpartum hemorrhage management in non-academic centers , 2015, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[107]  Louis P Halamek,et al.  Impact of a novel decision support tool on adherence to Neonatal Resuscitation Program algorithm. , 2015, Resuscitation.

[108]  I. Chertok,et al.  Evaluation of a midwife- and nurse-delivered 5 A's prenatal smoking cessation program. , 2015, Journal of midwifery & women's health.

[109]  R. Gee,et al.  Racial and ethnic disparities in maternal morbidity and mortality. , 2015, Obstetrics and gynecology.

[110]  J. Kirchner,et al.  A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project , 2015, Implementation Science.

[111]  H. Atrash,et al.  Putting the “M” Back in the Maternal and Child Health Bureau: Reducing Maternal Mortality and Morbidity , 2015, Maternal and Child Health Journal.

[112]  M. O’Connor,et al.  Use of a web-based education program improves nurses' knowledge of breastfeeding. , 2015, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[113]  Gila Neta,et al.  A Framework for Enhancing the Value of Research for Dissemination and Implementation. , 2015, American journal of public health.

[114]  J. Ferris,et al.  Impact of introducing Practical Obstetric Multi‐Professional Training (PROMPT) into maternity units in Victoria, Australia , 2014, BJOG : an international journal of obstetrics and gynaecology.

[115]  S. Gennaro,et al.  Sustainability of Improvements in Perinatal Teamwork and Safety Climate , 2014, Journal of nursing care quality.

[116]  Jai K Das,et al.  Approaches to improve the quality of maternal and newborn health care: an overview of the evidence , 2014, Reproductive Health.

[117]  Cyrille Colin,et al.  In Situ Simulation Training for Neonatal Resuscitation: An RCT , 2014, Pediatrics.

[118]  Jacqueline W. Miller,et al.  Quality assurance through quality improvement and professional development in the National Breast and Cervical Cancer Early Detection Program , 2014, Cancer.

[119]  R. Zoorob,et al.  Training nurses and nursing students about prevention, diagnoses, and treatment of fetal alcohol spectrum disorders. , 2014, Nurse education in practice.

[120]  K. Tocque,et al.  Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy , 2014, BMC Pregnancy and Childbirth.

[121]  D. Seybold,et al.  Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse , 2014, Journal of social work practice in the addictions.

[122]  S. Rubak,et al.  Training in motivational interviewing in obstetrics: a quantitative analytical tool , 2014, Acta obstetricia et gynecologica Scandinavica.

[123]  Karen Brady,et al.  An Interprofessional Quality Improvement Project to Implement Maternal/Infant Skin-to-Skin Contact During Cesarean Delivery , 2014, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[124]  Randall Brown,et al.  Study protocol for improving asthma outcomes through cross-cultural communication training for physicians: a randomized trial of physician training , 2014, BMC medical education.

[125]  J. Deprest,et al.  Development and use of a high‐fidelity simulator for fetal endotracheal balloon occlusion (FETO) insertion and removal , 2014, Prenatal diagnosis.

[126]  H. Hansen,et al.  Structural competency: Theorizing a new medical engagement with stigma and inequality , 2014, Social science & medicine.

[127]  Maree Johnson,et al.  Piloting of an oral health education programme and knowledge test for midwives , 2013, Contemporary nurse.

[128]  C. Berg,et al.  Maternal mortality and morbidity in the United States: where are we now? , 2014, Journal of women's health.

[129]  S. Firth,et al.  Do Strategies to Improve Quality of Maternal and Child Health Care in Lower and Middle Income Countries Lead to Improved Outcomes? A Review of the Evidence , 2013, PloS one.

[130]  Enola K Proctor,et al.  Implementation strategies: recommendations for specifying and reporting , 2013, Implementation Science.

[131]  Hossam Hamdy,et al.  Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83 , 2013, Medical teacher.

[132]  R. Fox,et al.  Retention of factual knowledge after practical training for intrapartum emergencies , 2013, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[133]  R. Guillet,et al.  Interdisciplinary Simulation-Based Training to Improve Delivery Room Communication , 2013, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[134]  Steven C. Rogers,et al.  Can nurse education in the postpartum period reduce car seat misuse among newborns? , 2013, The journal of trauma and acute care surgery.

[135]  N. Krumwiede,et al.  Simulation Enhances Self-Efficacy in the Management of Preeclampsia and Eclampsia in Obstetrical Staff Nurses , 2013 .

[136]  T J Draycott,et al.  Usability of virtual‐reality simulation training in obstetric ultrasonography: a prospective cohort study , 2013, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[137]  V. LeBlanc,et al.  'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial , 2013, Trials.

[138]  P. Conner,et al.  Education in obstetrical ultrasound – an important factor for increasing the prenatal detection of congenital heart disease , 2013, Acta obstetricia et gynecologica Scandinavica.

[139]  Amy Smith,et al.  Increasing certified nurse-midwives' confidence in managing the obstetric care of women with female genital mutilation/cutting. , 2013, Journal of midwifery & women's health.

[140]  Kimberly Eaton Hoagwood,et al.  Understanding the components of quality improvement collaboratives: a systematic literature review. , 2013, The Milbank quarterly.

[141]  W. Grobman,et al.  Interdisciplinary Collaboration to Maintain a Culture of Safety in a Labor and Delivery Setting , 2013, The Journal of perinatal & neonatal nursing.

[142]  M. Druzin,et al.  Response times for emergency cesarean delivery: use of simulation drills to assess and improve obstetric team performance , 2013, Journal of Perinatology.

[143]  D. Delgado,et al.  Cultural Competence Training for Clinical Staff , 2013, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[144]  Alison White,et al.  A service-based approach to nurse training in sexual and reproductive health care , 2013, Journal of family planning and reproductive health care.

[145]  Sara Bayes,et al.  Australian maternity health professionals' experience of an e-learning fetal surveillance package , 2013 .

[146]  Kathy L. MacLaughlin,et al.  Increased Adherence to Prenatal Group B Streptococcal Screening Guidelines Through a Paired Electronic Reminder and Education Intervention , 2013, Maternal and Child Health Journal.

[147]  L. Davidson,et al.  Seven Essential Strategies for Promoting and Sustaining Systemic Cultural Competence , 2013, Psychiatric Quarterly.

[148]  Abraham Wandersman,et al.  Toward an Evidence-Based System for Innovation Support for Implementing Innovations with Quality: Tools, Training, Technical Assistance, and Quality Assurance/Quality Improvement , 2012, American journal of community psychology.

[149]  S. Houterman,et al.  Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial , 2012, BJOG : an international journal of obstetrics and gynaecology.

[150]  J. Marshall Developing midwifery practice through work-based learning: an exploratory study. , 2012, Nurse education in practice.

[151]  D. Roter,et al.  “This Is a Decision You Have to Make”: Using Simulation to Study Prenatal Counseling , 2012, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[152]  A. Levi,et al.  Midwives and abortion care: a model for achieving competency. , 2012, Journal of midwifery & women's health.

[153]  M. Hacker,et al.  Assessment of long-term knowledge retention following single-day simulation training for uncommon but critical obstetrical events , 2012, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[154]  Leah Kaufman,et al.  Comprehensive Perinatal Safety Initiative to Reduce Adverse Obstetric Events , 2012, Journal for healthcare quality : official publication of the National Association for Healthcare Quality.

[155]  Maureen G Phipps,et al.  Outcomes from a labor and delivery team training program with simulation component. , 2012, American journal of obstetrics and gynecology.

[156]  Maree Johnson,et al.  Development of an Online Education Program for Midwives in Australia to Improve Perinatal Oral Health , 2012, The Journal of Perinatal Education.

[157]  M. Fitzpatrick,et al.  Sexual assault forensic examiners' training and assessment using simulation technology. , 2012, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[158]  J. Davila,et al.  Educating Health Professionals in Obstetrics and Gynecology Regarding Rapid Human Immunodeficiency Virus (HIV) Testing in Labor and Delivery: A Local Initiative , 2012, Maternal and Child Health Journal.

[159]  L. Lewin,et al.  An Internet-based education program improves breastfeeding knowledge of maternal-child healthcare providers. , 2011, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[160]  D. Ayres-de-Campos,et al.  Self-perceived impact of simulation-based training on the management of real-life obstetrical emergencies. , 2011, European journal of obstetrics, gynecology, and reproductive biology.

[161]  M. Bajka,et al.  Hysteroscopic placement of tubal sterilization implants: virtual reality simulator training , 2011, Surgical Endoscopy.

[162]  K. Hegarty,et al.  Identifying and supporting women with psychosocial issues during the postnatal period: evaluating an educational intervention for midwives using a before-and-after survey. , 2011, Midwifery.

[163]  Anthony Lathrop,et al.  Learner portfolios and hands-on workshop to facilitate and evaluate nurses' learning in obstetric ultrasound. , 2011, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[164]  J. Osborne,et al.  The SUCCESS program for smoking cessation for pregnant women. , 2011, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[165]  M. Stitely,et al.  Assessment of a simulation training exercise to teach intrauterine tamponade for the treatment of postpartum hemorrhage. , 2011, Journal of midwifery & women's health.

[166]  C. Wallman,et al.  Implementing a Perinatal Substance Abuse Screening Tool , 2011, Advances in neonatal care : official journal of the National Association of Neonatal Nurses.

[167]  William Riley,et al.  Didactic and simulation nontechnical skills team training to improve perinatal patient outcomes in a community hospital. , 2011, Joint Commission journal on quality and patient safety.

[168]  R. Like Educating clinicians about cultural competence and disparities in health and health care. , 2011, The Journal of continuing education in the health professions.

[169]  J. Valliere,et al.  Statewide innovations to improve services for women with perinatal depression. , 2011, Nursing for women's health.

[170]  C. Lockwood,et al.  A comprehensive obstetrics patient safety program improves safety climate and culture. , 2011, American journal of obstetrics and gynecology.

[171]  D. Karl,et al.  Use of the Behavioral Observation of the Newborn Educational Trainer for teaching newborn behavior. , 2011, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[172]  R. Jardri,et al.  Impact of midwives' training on postnatal depression screening in the first week post delivery: a quality improvement report. , 2010, Midwifery.

[173]  C. Schmidt,et al.  Success of an educational intervention on maternal/newborn nurses' breastfeeding knowledge and attitudes. , 2010, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[174]  Alicia C. Bunger,et al.  Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda , 2010, Administration and Policy in Mental Health and Mental Health Services Research.

[175]  B. Kanki,et al.  Mobile in situ obstetric emergency simulation and teamwork training to improve maternal-fetal safety in hospitals. , 2010, Joint Commission journal on quality and patient safety.

[176]  T. Foster,et al.  Improving prenatal HIV screening with tailored educational interventions: an approach to guideline implementation , 2010, Quality and Safety in Health Care.

[177]  Jennene Greenhill,et al.  Clinical simulation in maternity (CSiM): interprofessional learning through simulation team training , 2010, Quality and Safety in Health Care.

[178]  M. Foureur,et al.  The development and initiation of the NSW Department of Health interprofessional Fetal welfare Obstetric emergency Neonatal resuscitation Training project , 2010, The Australian & New Zealand journal of obstetrics & gynaecology.

[179]  L. Caley,et al.  Results of a nurse-led workshop designed to prevent fetal alcohol spectrum disorder. , 2010, Public health nursing.

[180]  Joseph R Betancourt,et al.  Commentary: linking cultural competence training to improved health outcomes: perspectives from the field. , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[181]  E. Main,et al.  Effective Implementation Strategies and Tactics for Leading Change on Maternity Units , 2010, The Journal of perinatal & neonatal nursing.

[182]  E. Goldlust,et al.  Improving parent satisfaction: an intervention to increase neonatal parent–provider communication , 2009, Journal of Perinatology.

[183]  J. Lowery,et al.  Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science , 2009, Implementation science : IS.

[184]  Keiko Abe,et al.  The use of simulated patients in medical education: AMEE Guide No 42 , 2009, Medical teacher.

[185]  A. Kumagai A conceptual framework for the use of illness narratives in medical education. , 2008, Academic medicine : journal of the Association of American Medical Colleges.

[186]  Agustín Ciapponi,et al.  Strategies for improving the quality of health care in maternal and child health in low- and middle-income countries: an overview of systematic reviews. , 2008, Paediatric and perinatal epidemiology.

[187]  S. Russell An overview of adult-learning processes. , 2006, Urologic nursing.

[188]  Tami L. Remington,et al.  Evaluation of evidence for interprofessional education. , 2006, American journal of pharmaceutical education.

[189]  Z. Bhutta Bridging the equity gap in maternal and child health , 2005, BMJ : British Medical Journal.

[190]  H. Arksey,et al.  Scoping studies: towards a methodological framework , 2005 .

[191]  Rodney K. Hopson,et al.  Cultural competence in evaluation: An overview , 2004 .

[192]  V. Hogan,et al.  Commentary: Eliminating Disparities in Perinatal Outcomes—Lessons Learned , 2004, Maternal and Child Health Journal.

[193]  C. Victora,et al.  Applying an equity lens to child health and mortality: more of the same is not enough , 2003, The Lancet.

[194]  Jeremy M. Grimshaw,et al.  Changing Provider Behavior: An Overview of Systematic Reviews of Interventions , 2001, Medical care.

[195]  M. Cabana,et al.  Why don't physicians follow clinical practice guidelines? A framework for improvement. , 1999, JAMA.