Content analysis of team communication in an obstetric emergency scenario.

We studied a random sample of four teams of doctors and midwives who participated in a videotaped simulated obstetric emergency, postpartum haemorrhage, before and after 'on-site' clinical training. We aimed to assess the validity of mixed techniques for the analysis of team communication and whether clinical and non-clinical team training improve communication. Two of the four teams received extra training in specific teamwork behaviours (TW+), the other half received only clinical training (TW-). We used content analysis to identify changes in communication patterns. There was a reduction in the total number of communications after training. Teams that received additional teamwork training used more directed commands after training. When commands were directed to specific individuals, tasks were more likely to be acknowledged and performed. We conclude that 'on-site' clinical drills can improve team communication in simulated emergencies, and additional teamwork training might improve this further, but it has to be refined and made obstetric specific first.