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Peer-reviewedCC BY 4.0Cureus

Simulation-Based Outreach Program to Support Community Hospitals’ Team Readiness for Obstetric Emergencies Across a Rural Health System

  • Jesse M Rideout1,2
  • Micheline Chipman3
  • Beth Gray3
  • Rebecca Hunt4,5
  • Emily Watson4
  • Sarah Austin4
  • Anya Cutler6
  • Lauren Weller7
  • Jeffrey A Holmes1,2
  • Leah Mallory8,9
9 affiliations
  1. 1Emergency Medicine, MaineHealth Maine Medical Center, Portland, USA
  2. 2Emergency Medicine, Tufts University, Boston, USA
  3. 3Medical Education and Simulation, MaineHealth Maine Medical Center, Portland, USA
  4. 4Obstetrics and Gynecology, MaineHealth Maine Medical Center, Portland, USA
  5. 5Obstetrics and Gynecology, Tufts University, Boston, USA
  6. 6Center for Outcomes Research and Evaluation, MaineHealth Maine Medical Center, Portland, USA
  7. 7Medical Education and Simulation, Tufts University, Boston, USA
  8. 8Pediatrics, MaineHealth Maine Medical Center, Portland, USA
  9. 9Pediatrics, Tufts University, Boston, USA
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Abstract

Background

Rural hospitals face persistent challenges in sustaining readiness for obstetric emergencies due to declining birth volumes, workforce shortages, and limited opportunities for hands-on practice. The Maine Obstetrical Medical Simulation (MOMSim) program was developed to support interprofessional team preparedness across a rural health system. This study evaluated program implementation and its impact on participants’ confidence in managing obstetric emergencies.

Methodology

An in situ, simulation-based obstetric emergency training program was delivered across eight community hospitals within a rural health system from 2022 to 2025. Each site received two half-day training visits approximately one year apart. The curriculum incorporated targeted skills stations, high-fidelity in situ simulations, and structured debriefings. Participant demographic information was collected, and anonymous pre- and post-training surveys assessed confidence across multiple domains on a five-point Likert scale. Linear mixed-effects models evaluated aggregate pre- and post-training changes across sites and visits and differences in baseline confidence between the first and second visit; confidence was also compared across hospital sites and professions.

Results

Across 16 training sessions, 287 interprofessional participants engaged in the program. Confidence increased significantly across all assessed domains following training, with mean improvements ranging from 0.24 (95% confidence interval (CI) = 0.11-0.37) to 0.51 (95% CI = 0.35-0.68) Likert points. No significant differences in baseline confidence were observed between visits. Pre-training comparisons between sites identified significant differences in perceived resources, team confidence, and team cohesion.

Conclusions

The MOMSim program was successfully implemented across a geographically dispersed rural health system and was associated with significant improvements in interprofessional team confidence. Systemwide simulation outreach may provide a feasible approach to strengthening obstetric emergency preparedness and team-based readiness of low-volume rural delivery units.

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Cite

BibTeXRIS
BibTeX
@article{rideout2026simulationbased,
  title = {{Simulation-Based Outreach Program to Support Community Hospitals’ Team Readiness for Obstetric Emergencies Across a Rural Health System}},
  author = {Jesse M Rideout and Micheline Chipman and Beth Gray and Rebecca Hunt and Emily Watson and Sarah Austin and Anya Cutler and Lauren Weller and Jeffrey A Holmes and Leah Mallory},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.117482},
  url = {https://doi.org/10.7759/cureus.117482},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Simulation-Based Outreach Program to Support Community Hospitals’ Team Readiness for Obstetric Emergencies Across a Rural Health System
AU  - Jesse M Rideout
AU  - Micheline Chipman
AU  - Beth Gray
AU  - Rebecca Hunt
AU  - Emily Watson
AU  - Sarah Austin
AU  - Anya Cutler
AU  - Lauren Weller
AU  - Jeffrey A Holmes
AU  - Leah Mallory
PY  - 2026
DA  - 2026/10/05
JO  - Cureus
DO  - 10.7759/cureus.117482
UR  - https://doi.org/10.7759/cureus.117482
AB  - Background  Rural hospitals face persistent challenges in sustaining readiness for obstetric emergencies due to declining birth volumes, workforce shortages, and limited opportunities for hands-on practice. The Maine Obstetrical Medical Simulation (MOMSim) program was developed to support interprofessional team preparedness across a rural health system. This study evaluated program implementation and its impact on participants’ confidence in managing obstetric emergencies.  Methodology  An in situ, simulation-based obstetric emergency training program was delivered across eight community hospitals within a rural health system from 2022 to 2025. Each site received two half-day training visits approximately one year apart. The curriculum incorporated targeted skills stations, high-fidelity in situ simulations, and structured debriefings. Participant demographic information was collected, and anonymous pre- and post-training surveys assessed confidence across multiple domains on a five-point Likert scale. Linear mixed-effects models evaluated aggregate pre- and post-training changes across sites and visits and differences in baseline confidence between the first and second visit; confidence was also compared across hospital sites and professions.  Results  Across 16 training sessions, 287 interprofessional participants engaged in the program. Confidence increased significantly across all assessed domains following training, with mean improvements ranging from 0.24 (95% confidence interval (CI) = 0.11-0.37) to 0.51 (95% CI = 0.35-0.68) Likert points. No significant differences in baseline confidence were observed between visits. Pre-training comparisons between sites identified significant differences in perceived resources, team confidence, and team cohesion.  Conclusions  The MOMSim program was successfully implemented across a geographically dispersed rural health system and was associated with significant improvements in interprofessional team confidence. Systemwide simulation outreach may provide a feasible approach to strengthening obstetric emergency preparedness and team-based readiness of low-volume rural delivery units.
SN  - 2168-8184
ER  -