| Study characteristics |
| Methods |
Randomised controlled trial to compare simulation‐based obstetric team training with didactics. |
| Participants |
32 trainees: labour and delivery nurses and obstetric residents (16 trainees in each study group). Each team had 4 staff members. |
| Interventions |
A 3‐hour simulation‐based team training (in a simulation centre) versus didactic instruction. Training content: crisis resource management, eclampsia, shoulder dystocia. |
| Outcomes |
Knowledge (pre‐ and (1‐month) post‐intervention) and performance after 1 month. |
| Notes |
Single‐centre study, USA. Study period: 2006‐2007. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Quote: "using a computer randomisation program." |
| Allocation concealment (selection bias) |
Low risk |
Quote: "After the teams were formed, they were randomly assigned to either the Did or Sim group, using a computer randomisation program." |
| Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
Not noted, probably not done. Low impact on objective outcome measures. |
| Blinding of outcome assessment (detection bias)
All outcomes |
Low risk |
Quote: "The reviewer was familiar with some of the participants but completely blinded to the type of training provided to each team." Unclear whether the assessor of the MCQ was blinded, however unlikely that this might have influenced the results. |
| Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
There were 3/16 withdrawals in the didactics group and 2/16 in the simulation group. Their prior MCQ results were excluded. Although reasons for withdrawals were not mentioned, numbers in both groups are comparable and unlikely to be related to true outcome. |
| Selective reporting (reporting bias) |
Low risk |
None 'not reported outcome's noted. No study protocol available. |
| Other bias |
Low risk |
None noted. |
