{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:25:39Z","timestamp":1790105139402,"version":"4.0.1"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,10,10]],"date-time":"2016-10-10T00:00:00Z","timestamp":1476057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["170992303"],"award-info":[{"award-number":["170992303"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether simulation\u2010based obstetric team training in a simulation centre improves patient outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicentre, open, cluster randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Obstetric units in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Women with a singleton pregnancy beyond 24 weeks of gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Random allocation of obstetric units to a 1\u2010day, multi\u2010professional, simulation\u2010based team training focusing on crew resource management (\n                      <jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content>\n                      ) in a simulation centre or to no such team training. Intention\u2010to\u2010treat analyses were performed at the cluster level, including a measurement 1 year prior to the intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Primary outcome was a composite outcome of obstetric complications during the first year post\u2010intervention, including low Apgar score, severe postpartum haemorrhage, trauma due to shoulder dystocia, eclampsia and hypoxic\u2010ischaemic encephalopathy. Maternal and perinatal mortality were also registered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each study group included 12 units with a median unit size of 1224 women, combining for a total of 28 657 women. In total, 471 medical professionals received the training course. The composite outcome of obstetric complications did not differ between study groups [odds ratio (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ) 1.0, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ) 0.80\u20131.3]. Team training reduced trauma due to shoulder dystocia (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      0.50, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.25\u20130.99) and increased invasive treatment for severe postpartum haemorrhage (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      2.2, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.2\u20133.9) compared with no intervention. Other outcomes did not differ between study groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 1\u2010day, off\u2010site, simulation\u2010based team training, focusing on teamwork skills, did not reduce a composite of obstetric complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>1\u2010day, off\u2010site, simulation\u2010based team training did not reduce a composite of obstetric complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.14369","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T08:53:25Z","timestamp":1476348805000},"page":"641-650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Simulation\u2010based team training for multi\u2010professional obstetric care teams to improve patient outcome: a multicentre, cluster randomised controlled trial"],"prefix":"10.1111","volume":"124","author":[{"given":"AF","family":"Fransen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology M\u00e1xima Medical Centre Eindhoven\u2010Veldhoven the Netherlands"},{"name":"Department of Obstetrics and Gynaecology Maastricht University Medical Centre Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"van de Ven","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology M\u00e1xima Medical Centre Eindhoven\u2010Veldhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Schuit","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands"},{"name":"Stanford Prevention Research Center Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AAC","family":"van Tetering","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology M\u00e1xima Medical Centre Eindhoven\u2010Veldhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BW","family":"Mol","sequence":"additional","affiliation":[{"name":"The Robinson Institute School of Paediatrics and Reproductive Health University of Adelaide and the South Australian Health and Medical Research Institute Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SG","family":"Oei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology M\u00e1xima Medical Centre Eindhoven\u2010Veldhoven the Netherlands"},{"name":"Department of Electrotechnical Engineering Eindhoven University of Technology Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12248"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-219"},{"key":"e_1_2_6_4_1","volume-title":"Why Mothers Die 2000\u20132002","author":"Confidential Enquiry into Maternal and Child Health (CEMACH)","year":"2004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02847.x"},{"key":"e_1_2_6_6_1","volume-title":"To Err Is Human; 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