Background: The IMPROVE workshop is designed to address the educational needs of health professionals providing clinical care around the time of perinatal loss, based on the Perinatal Society of Australia and New Zealand (PSANZ)/Stillbirth CRE Care Around Stillbirth and Neonatal Death (CASaND) guideline. In 2023, NT Health funded an IMPROVE Train-the-Trainer (TTT) program to credential local staff to be IMPROVE educators. In 2024, the NT Health team coordinated two IMPROVE workshops delivered by local educators.
Objective: To evaluate the user experience the IMPROVE workshops held in the Northern Territory (NT) in 2024.
Methods: Evaluation of participant knowledge and confidence in each of the six stations in the workshops was undertaken using an on-line survey administered immediately before and after the workshop. Participants provided additional feedback including suggestions for improvement, areas of usefulness and general comments. Questions measuring knowledge and confidence were rated on a 5-point scale (strongly disagree = 1 and strongly agree = 5). The proportion of participants who selected ‘agree’ or ‘strongly agree’ for each survey question was measured pre- and post-workshop. Furthermore, knowledge and confidence scores for the overall workshop were also calculated using the 5-point scale and ranged from 18-90. Scores were represented as mean ± standard deviation and p-values were calculated using an unpaired t-test.
Results: A total of 24 participants attended the NT Health IMPROVE TTT program in 2023 (20 midwives, 2 obstetricians and 2 neonatologists). 67% of attendees reported ‘very good’ or ‘excellent’ understanding of perinatal mortality review practices post the workshop (vs 31% pre). 95% of attendees rated the workshop ‘excellent’ or ‘very good’. Of the 24 TTT participants, six taught at the subsequent NT workshops in 2024 (the majority of which were midwives teaching multiple stations).
Twenty- three clinicians attended the two IMPROVE NT workshops held in 2024 (July and November), with 13 participants providing pre-evaluation and 16 participants providing post-evaluation data online-surveys.
All measures of knowledge and confidence showed substantial improvement post-workshop for all stations. Improvements were clearly demonstrated across all six stations, with the percentage of participants who selected ‘strongly agree’ and ‘agree’ in the pre-evaluation ranging from 33% to 78% and post-evaluation survey results ranging from 92 to 100%. The largest improvements were shown in Station 3 (investigation of stillbirth) with 33% pre-evaluation [vs 92% post]. Furthermore, knowledge and confidence scores were found to be significantly improved pre, post-workshop (57.31 ± 12.92 vs 81.25 ± 9.284,p <0.0001). Feedback from the participants was very positive.
Conclusion: Improving health care professionals’ knowledge and confidence in best practice bereavement care is an important strategy to ensure that every family receives the very best care at the worst of times, which aligns with high quality midwifery care. The IMPROVE education program in the NT appears to a beneficial part of this strategy. Participants recorded a high level of satisfaction across all six stations of the workshop. Importantly, credentialing local educators supports the continued implementation and sustainability of the IMPROVE program in the NT, thereby enhancing the perinatal loss workforce, with midwives constituting the largest component.