Date of Award

12-19-2024

Degree Type

Thesis

Degree Name

Master of Health Professions Education

First Advisor

Dr. Shazia Babar

Second Advisor

Dr. Sana Saeed

Third Advisor

Dr. Vaqar Bari

Department

Educational Development

Abstract

Background: Shoulder Dystocia is an emergency which needs to be managed holistically to reduce maternal morbidity and neonatal morbidity and mortality. It affects 0.1-3% of all births. Shoulder dystocia emergency is managed by a team of physicians and nurses working together. Both physicians and nurses must play their part for a good outcome. The management of shoulder dystocia requires technical and non-technical skills. However, both physicians and nurses are trained separately, and these skills are not practiced in teams. There is no tool available in literature to assess the technical and non-technical skills of physicians and nurses. Therefore, there is a pressing need to develop a valid and reliable tool for assessing obstetric teams on technical and non-technical skills in management of shoulder dystocia. This study aims to develop a valid and reliable tool for assessing obstetric teams on technical and non-technical skills in management of shoulder dystocia.
Methodology: This was a tool validation study conducted at Aga Khan University, Karachi between March 2024 to October 2024. The tool was developed through extensive literature review and expert opinion. It comprised of items related to technical and non-technical skills required for the management of shoulder dystocia. Content validation was performed by including 9 experts and content validity index (CVI) was calculated. After the accessor’s training, the tool was implemented on interprofessional teams of residents, medical officers and nursing staff of the labor room, selected through universal sampling. A total of 12 teams with 4-6 members were created and assessed independently by three assessors. The statistical analysis was performed using SPSS 19. Cronbach’s alpha was calculated to determine internal consistency of the scores while inter rater reliability was determined by interclass correlation coefficient (ICC).
Result: The original tool comprised a total of 29 items. Six items were deleted after the performing expert content validation (CVI < 0.8). The reliability analysis showed Cronbach’s alpha of 23 items was 0.89. ICC of 13 items was found to be excellent (0.77 to 0.99).
Conclusion: The newly developed Team Objective Structured Assessment of technical and non-technical Skills (TOSAT-D) is a reliable tool to assess the competencies of interprofessional team on shoulder dystocia management.

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1

Last Page

53

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