Effectiveness of Communication Interventions in Obstetrics-A Systematic Review

Abstract

(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched for studies published in peer-reviewed journals in English or German between 2000 and 2020. Out of 7018 results, 71 studies were included and evaluated in this synthesis using the Oxford Level of Evidence Scale. (3) Results: The 63 studies that included a communication component revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies revealed a beneficial effect of communication trainings on distal performance indicators (i.e., patient safety), but only to a limited extent. Most studies simultaneously examined different groups, however, those addressing healthcare providers were more common than those with students (61 vs. 12). Only nine studies targeted expectant mothers. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies with an evidence level I-II, 35 with level III, and 10 with level IV. (4) Conclusions: Communication trainings should be more frequently applied to improve communication of staff, students, and pregnant women and their partners, thereby improving patient safety.

Keywords: communication; interprofessional; intervention; learning; midwifery; obstetrics; patient safety; training.

Figure 1

Systematic search method and inclusion/exclusion criteria. Note: ¹ Inclusion criteria: Publications in English or German; published between 2000 and 2020; human subjects; peer-reviewed journal. ² Inclusion criteria: Clinical or educational obstetrics setting; communication as an intervention or outcome variable; empirical data. ³ Inclusion criteria: Communication intervention or an intervention that includes communication or that measures the change in communication; exclusion criteria: No empirical study (e.g., editorial, opinion, abstract); incomplete or unclear reporting of key information (e.g., construct definition, measurement methods, analyses, statistical indices); duplicate publication; wrong setting or no obstetrics-specific data; no intervention; no change measured.

Figure 2

The number of studies rated by their level of evidence as an indicator for the robustness of a study’s findings.