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Job role and stress influence student movement during postpartum haemorrhage simulation: an exploratory study
  1. Rachel Bican1,
  2. Jill C Heathcock1,
  3. Flora Jedryszek2,
  4. Veronique Debarge2,3,4,
  5. Julien DeJonckheere4,
  6. M C Cybalski3,
  7. Sandy Hanssens2,3
  1. 1 Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
  2. 2 Department of Obstetrics, Regional and University Hospital Centre Lille, Lille, France
  3. 3 Midwives School, Regional and University Hospital Centre Lille, Lille, France
  4. 4 Perinatal Environment and Health, Regional and University Hospital Centre Lille, Lille, France
  1. Correspondence to Jill C Heathcock, Department of Physical Therapy; The Ohio State University, 516 Atwell Hall 453 W. 10th Avenue, Columbus, OH, USA; jill.heathcock{at}


Introduction Postpartum haemorrhage is the leading cause of maternal death. Healthcare simulations are an educational tool to prepare students for infrequent high-risk emergencies without risking patient safety. Efficiency of movement in the simulation environment is important to minimize the risk of medical error. The purpose of this study was to quantify the movement behaviours of the participants in the simulation and evaluate the relationship between perceived stress and movement.

Methods N=30 students participated in 10 high-fidelity medical simulations using an adult patient simulator experiencing a postpartum haemorrhage. The participants completed the State-Trait Anxiety Inventory prior to the simulation to measure perceived stress. Physical movement behaviours included walking around the simulation, time spent at bedside, arm movements, movements without purpose, looking at charts/vitals and total movement.

Results Midwife (MW) students spent significantly more time walking (p=0.004) and looking at charts/vitals (p=<0.001) and significantly less time at bedside (p=<0.001) compared to obstetric (OB) students. The MW students demonstrated significantly more total movements compared to the OB students (p=<0.001). There was a significant, moderate, positive relationship between perceived stress and total movement during the simulation for the MW group (r=0.50, p=0.05). There was a trend for a moderate, positive relationship between perceived stress and total movement during the simulation for the OB group (r=0.46, p=0.10).

Conclusions Physical movement during a simulation varies by job role and is influenced by perceived stress. Improved understanding of physical movement in the simulation environment can improve feedback, training and environmental set-up.

  • Simulation BasedSimulation-Based Learning
  • healthcare
  • Interdisciplinary Training
  • Simulation BasedSimulation-Based Education
  • Obstetric Emergencies

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  • Contributors RB and JCH developed the coding manual for movement assessment, scored the video data and conducted the analysis; RB, JCH, FJ, VD, MCC, SH and JD collected data; FJ, VD, MCC and SH planned the educational experience and chose the perceived stress measure; RB, JCH, VD and SH were involved in writing, editing and revising sections of the manuscript; JCH servers as primary guarantor.

  • Funding This work was supported in full/part by the Florence P. Kendall Doctoral Scholarship from the Foundation for Physical Therapy Research to R. Bican and a Fulbright-Hays award to J. Heathcock. These funding sources do not have associated numbers.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Institutional review board The procedures and experiments were approved by the Research Ethics Committee of The Ohio State University (2018E0096). The protocol for this study was considered exempt and consent did not need to be obtained.

  • Data availability statement No data are available.

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