Applied drama techniques in obstetrics: a novel educational workshop for the management of stillbirth

Applied drama techniques in obstetrics: a novel educational workshop for the management of stillbirth

K McNamara (1), A Smyth (2), B Shine (3), M Cregan (4), L Prihodova (2), A O’Shaughnessy (2), A Martin (3), J MacDonald (5), P Kingston (5), C Fitzpatrick (3,6), K O’Donoghue (1,7)

1. Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork (UCC), Ireland, 2. Royal College of Physicians of Ireland, Dublin, Ireland. 3. The Coombe Women and Infants University Hospital, Dublin, Ireland. 4. Feileacain, Stillbirth and Neonatal Death association of Ireland, Cork, Ireland. 5. The Abbey Theatre, Dublin, Ireland. 6. UCD Centre for Human reproduction, Dublin, Ireland. 7. The Irish Centre for Fetal and Neonatal Translational Research, UCC, Ireland.

Background
Obstetricians have described feeling shocked and isolated in the aftermath of a stillbirth. Research shows that few receive adequate training in how to care for parents following a stillbirth, or on their own self-care skills. We developed a new innovative workshop for obstetricians, in collaboration with the drama department from the Irish National theatre, which uses applied drama to teach obstetricians skills in communication, self-care and self-efficacy in breaking bad news. The aim of this study was to evaluate this new workshop.

Methods
Senior trainees in Obstetrics and Gynaecology (n=74) were invited to attend and
complete a post-workshop evaluation questionnaire. Five point Likert scales were used to assess participant’s feedback on the workshop. A paired-sample t-test with a significance level set at
0.05 was used to test for self-reported changes in the skills and attributes of the trainees following the workshop.

Results
39/59(66%) trainees who attended completed the evaluation questionnaires. Most had received no prior formal training in stillbirth management(34/39, 87.2%). Following the workshop, there was a statistically significant improvement in trainee’s level of confidence in breaking bad news, communicating clearly with the family when breaking bad news, recognising the emotional needs of the family, recognising their own emotional responses and supporting their colleagues. Trainees were overall positive about the course content and would recommend the workshop to a colleague.

Conclusion
This study evaluated the impact that a novel educational workshop had on improving obstetricians’
awareness of compassion, communication and self care around the time of stillbirth. We identified a
subjective improvement in some of the key skills that obstetricians must have when caring and
communicating with bereaved parents. We recommend that this training should be incorporated into the core postgraduate curriculum in Obstetrics.

Ethics Statement
This study received full ethical approval from the RCPI Ethics Committee ( RECSAF17). Participation in this study was via voluntary feedback and signed consent forms were obtained from each participant prior to inclusion in the study

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