Room of Knowledge (RoK): An initiative to encourage ad-hoc multi-disciplinary practical teaching

ABSTRACT

Objective: Clinical skill development is an essential part of speciality training in Obstetrics and Gynaecology. The COVID-19 pandemic has profoundly affected this with the move to remote learning, social distancing rules, increased workload, staff shortages and re-deployment. In order to improve access to clinical skills training it is imperative that we utilise the time spent in clinical settings such as labour ward and theatres to maximise training opportunities and skill development. Design: Qualitative study. Method: A pre-implementation online survey was carried out to analyse clinical skill training opportunities available to obstetric trainees and midwives on labour ward. In accordance with survey results, a trolley was assembled with the required equipment and easy to follow guides for carrying out several practical procedures and management of key emergency scenarios. The initial procedures and scenarios covered included;management of labour and delivery, post-partum haemorrhage, suturing and intrauterine device insertion. A log of the trolley's usage is being maintained and a follow up survey will be carried out in 3 months. Results: As per the initial survey, 90% of the respondents said that they were involved in ad hoc teaching only once a month or less. More than 80% trainees reported that they found impromptu teaching using models and aids on labour ward very useful and more than 95% said that they would attend such training if available. The most common procedures and/or skills identified as areas that should be covered included suturing, fetal scalp electrode attachment, breech vaginal birth and instrumental delivery. This project has significantly boosted the clinical teaching in our unit. The initial response from the log records revealed regular use on daily basis by trainee doctors as well as midwives. Operative vaginal delivery is the most utilised procedure to date. The first follow up survey will be conducted in April to assess the impact and analyse the scope for further expansion to include other aspects such as CTG training. Conclusion: The presence of the trolley along with materials and aids has helped create a learning environment on the labour ward with more frequent impromptu training even during busy shifts. It has instilled great enthusiasm amongst the trainees as well as trainers as evident from the verbal feedback and log records. A follow up survey and its statistical analysis will be carried out to substantiate our conclusion.