Exploring the trainee experience during a combined technical and non-technical skills obstetric training session on a simulated labour ward: A rapid ethnographic study

Abstract Background: Obstetric training requires competence in both technical and non-technical skills (TS and NTS). Traditionally the acquisition of these skills is dependent on experience more than formal teaching. Simulation training can be an opportunity to bridge this gap in a safe environment. This study explores the impact of merging TS and NTS simulation into a single session of an obstetric on call on a simulated labour ward. Methods: All obsetric specialist trainees year 1 and 2 (ST1-2) from the Thames Valley Deanery (n = 14) participated in a 40 minute simulated labour ward oncall,managing patients on the labour and antenatal wards and maternity assessment unit. The trainees were divided into two groups, each group participated in the simulation followed by a focus group discussion. This study used rapid ethnography with in-situ observation, audio recordings, field notes and focus group interviews. Data analysis used Kopta’s 3 phase theorical framework of technical skill learning- cognitive, integrative and autonomous. Results: Trainees learnt TS in all three Kopta’s phases during this simulation. The trainee’s familiarity with the TS determined the phase of learning they achieved. For less familiar tasks, trainees were in the cognitive phase. The integrative phase was seen when the TS was partially familiar and required them to perform it in conjunction with the appropriate NTS. There was autonomous TS and NTS integration with tasks they were skilled in. Conclusion: Integrating TS and NTS simulation optimised the learning opportunities within one training session. This model is adaptable to various skill levels and specialities, without increasing trainee, faculty, or resource burden. Further exploration can broaden applicability of this approach across other specialities.