REPORT OF THE TRAINING PROGRAMME ON MANAGING MEDICAL AND OBSTETRIC EMERGENCIES AND TRAUMA (mMOET)

DSC_0155Introduction:

The first two mMOET courses in West Africa, were organised by the department of Obstetrics and Gynaecology of the College of Medicine, University of Lagos/Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, in collaboration with Dr Adebimpe Matiluko of the University of Leicester, UK and the Maternal and Reproductive Health Research Collective, Lagos Nigeria. They took place between the 27th and 28th of May (first course) and the 29th and 30th of May (second course), 2019.

The facilitators  were obstetricians and anaesthesiologists from the Advanced Life Support Group (ALSG) UK, in which the mMOET course copyright is domiciled. The training was designed to provide insight and understanding regarding the key concepts, discuss practical steps in management obstetrics emergencies and trauma. There were twenty candidates/ trainees in total, with ten candidates in each batch. Sterling Bank Plc sponsored the training, together with the above-mentioned collaborators.

Training Contents

The sessions started at 08:00 am and ended at 6:45 pm daily. The following core concepts were covered in the training programme:

  • E-Learning session and pre-course evaluation
  • Interactive structured approach to mMOET
  • CPR demonstration
  • Trauma demonstration
  • Shock
  • Medical emergencies
  • Obstetric emergencies
  • Advanced Obstetric skill techniques
  • Neonatal resuscitation
  • Simulations

Training Procedures – In summary:

There were pre-training e-learning sessions, followed by one hundred single best answer pre-training questions (computer based test) which were aimed at analysing the trainees’ existing knowledge of the subject matter and how much they already know about some of the topics which are to be discussed in the training.

The training session started with opening remarks by the Head, Department of Obstetrics and Gynaecology – Prof B.B Afolabi while the training was declared open by Prof F. E. A. Lesi, Provost College of Medicine, University of Lagos.Other management staff in attendance included the Chief Medical Director, LUTH – Prof Chris Bode,Prof Olufemi Fasanmade, Chairman Medical Advisory Committee, LUTH and Prof Adeyemi, the Dean, Faculty of Clinical Sciences, College of Medicine, University of Lagos.

Overview of the course was done by Dr. Adebimpe Matiluko – Course director and Consultant Obstetrician and Gynaecologist, which was followed by introduction of ALSG faculty members and the participants. There was a press conference organised by LUTH management.

The training went ahead as scheduled. There were demonstrations and simulations using mannequins to display major points of discussion and for hand-on sessions by the participants. The candidates shared their views, experiences about the simulations discussed and clarifications were made.There were twenty-four skill stations in all and each candidate was the team leader on at least five different occasions and directed to carry out the different drills. After each drill, there was a debrief with the facilitator for the specific station and corrections and clarifications as required. Each demonstration session had a total of 3-4 candidates at any given time.

Finally, an examination was done for each candidate after which there was an overall course evaluation conducted by the course director, which aimed to get feedback from the candidates. This evaluation was intended to obtain participants’ views about different aspects of the training – the effectiveness and coverage of the topics, and from the trainer’s knowledge and preparedness to their overall impression of the whole training. Suggestions were also made to establish clinics and appropriate antenatal referrals to attend to special areas in obstetrics- viz-a-viz mental health and anaesthesiologist review/ evaluations that would improve maternal and perinatal outcomes.

 

 Facilitation Techniques:

There were several facilitation techniques used by the trainers which included practical demonstration, simulations, brainstorming group discussions, and practical implementation of some of discussions by the candidates using mannequins and basic obstetric and anaesthetic tools/instruments.

Closing of the Training:

After the examination and resits, the trainers expressed their closing remarks and reiterated the importance of the training for the trainees and the country at large in reducing maternal/perinatal morbidity and mortality.Evidence of having passed the post-training examination was given to the participants pending receipt of original certificate. Certificates of completion were to be printed online by the participants upon completion of the online post-training feedback section.

 

Conclusion and Recommendation:

The training program was conducted successfully and all the participants took active part in all four days of the training.

It was recommended

  • That the training be domiciled in the department of Obstetrics and Gynaecology.
  • To train other medical and non-medical personnel/staff who are first contacts with obstetric emergencies in the emergency room as well as labour ward.
  • To make available grab boxes, algorithms, protocols on the management of obstetrics emergencies and trauma on emergency room and labour ward – these have already started.
  • To incorporate the SBAR approach into the morning reviews and OSCE practice sessions.
  • To organise the MOET training programme at least once every six months.
  • To source for sponsorship to ensure sustainability of the course.