Evaluation of an e-learning program of continuing midwifery education on postpartum hemorrhage

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  • e-learningによる分娩後出血対応に関する助産師継続教育プログラムの評価

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Abstract

Objective<br> The purpose of this study was to evaluate an e-learning program on postpartum hemorrhage (PPH) for midwives.<br>Methods<br> Participants were midwives who worked at an obstetrics ward at a hospital, birth clinic, or birth center in the Kanto area. The e-learning program consisted of four parts. We measured knowledge about PPH using a pre- and a posttest, and evaluated the program using questionnaires.<br>Results<br> We analyzed 48 midwives. Knowledge scores significantly increased from the pre- to posttest (t = 10.27, p < .001). The average total score on the knowledge pretest was 15.85 (range 11-21, SD 2.78) and posttest 20.02 (range 14-23, SD 2.21).<br> The percentage of questions correctly answered significantly increased with respect to 12 items: "characteristics of atonic bleeding," "clotting factors and hemorrhage," "percentage decrease of circulating blood volume as a cause of hemorrhagic shock," "circulating blood volume of adults," "support for patients with hemorrhagic shock," "characteristics of dilutional coagulopathy," "configuration of extracellular fluid," "characteristics of obstetric disseminated intravascular coagulation syndrome (DIC)," "causes of increased blood volume," "circulating hemorrhage volume according to the shock index," "blood infusion," and "components of blood plasma." No significant changes were found for two items: "colloid oncotic pressure" and "crystalloid pressure."<br> Furthermore, we analyzed the relationship of the average total score with participants' characteristics (two-way factorial analysis of variance). No significant associations were detected. The design of the e-learning program was useful because of the positive assessment by the trainees of the mode of operation, appropriateness of the program, and overall satisfaction.<br>Conclusion<br> An e-learning program is an effective method for improving trainees' knowledge. There are limitations with regard to the effectiveness of teaching of physiology related to fluid therapy. We are planning on modifying the program; it required longitudinal assessment of knowledge retention.

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