Introduction: Traditional OSCEs, while reliable, are criticized for limited authenticity, delayed feedback, and high stress. The Clinical Assessment for Progression Examination (Clinical APEx), a new competency-based assessment at Monash, was developed to address these issues.Methods: We conducted an interpretivist qualitative interview study with 33 final-year medical students who completed both the Clinical APEx and OSCE, recruited via post-assessment survey and site-wide invitations. Semi-structured Zoom interviews were analysed using inductive reflexive thematic analysis.Results: Analysis revealed four key themes: Authenticity and Empathy, Feedback and Learning, Supportive Environment, and Challenges, which included concerns about standardisation, subjectivity, and under-assessment of clinical reasoning.Conclusion: Beyond describing a local innovation, this study highlights broader mechanisms of educational impact, particularly authenticity, feedback, and psychological safety, that can inform assessment design across contexts. The Clinical APEx serves as a case example for reimagining high-stakes assessment as assessment for learning rather than solely of learning. These findings provides conceptual insights as to how clinical assessments might be made both rigorous and developmentally meaningful.

BackgroundOperative vaginal birth (OVB) relies on effective teamwork to optimise outcomes. This study aims to explore providers' perspectives of factors influencing safety and team functionality at OVB.MethodsThis mixed methods study involved four maternity sites at Monash Health, Australia. Surveys sent to healthcare providers invited quantitative and qualitative appraisal of safety and team functionality at OVB. Semi-structured interviews further explored themes emerging from survey responses. Categorical survey data were compared between staff roles using Pearson's chi-squared tests. Thematic analysis of free-text survey responses and interviews identified themes influencing safety and team functionality at OVB.FindingsWe received 100 survey responses from obstetric (n = 41), midwifery (n = 52) and paediatric (n = 7) staff, including senior (n = 49) and junior (n = 51) roles. Overall, 99% thought team communication should improve and 82% had witnessed practices outside protocol. Obstetric versus midwifery or paediatric staff were less likely to rate communication as low or very low quality (5% vs. 29%, p = 0.010). Reporting being extremely or very confident to escalate concerns was more likely in obstetric versus midwifery or paediatric staff (49% vs.12%, p = 0.003) and senior versus junior staff (44% vs. 10%, p = 0.008). Five overarching themes impacted on team functionality at OVB; (1) Quality of communication, (2) Preparation and risk assessment, (3) Leadership and interpersonal dynamics, (4) Transfer from Birth Unit to Operating Theatre, (5) Variation in clinical practice.DiscussionSome care providers perspectives of team functionality at OVB differed, with midwifery and paediatric staff more likely to report challenges with communication and were less empowered to escalate concerns. Training in factors impacting team functionality at OVB should be considered.

Preparedness for practice (P4P) encompasses experience, knowledge, confidence, self-awareness, accountability, resilience, and competency, and is crucial to improved patient outcomes, healthcare team dynamics and doctor wellbeing. This study aimed to investigate graduating medical students’ perceptions of P4P. Graduating medical students from the class of 2022 at an Australian University were invited to voluntarily participate in the study. The cross-sectional exploratory study was developed using co-design (co-creation with faculty and medical students) and employed through a 69-question survey. The survey measured eight key competency areas using 5-point Likert confidence scales and 34 open-ended questions. Quantitative data was analysed using descriptive statistics. Text responses were analysed with qualitative description which drew upon thematic analysis and coding. A total of 365 graduating Doctor of Medicine students completed the survey (83

BACKGROUND:Poor outcomes from operative vaginal birth are associated with failure to recognize malposition, lack of interdisciplinary communication, and deviation from accepted guidelines. We implemented a safety bundle including routine intrapartum ultrasound, a structured time-out and procedural checklist, birth experience survey, and a postnatal debrief pathway. OBJECTIVE:To compare clinical outcomes from operative vaginal birth before and after the implementation of a safety bundle at Monash Health, Melbourne, Australia. STUDY DESIGN:We compared clinical outcomes prebundle vs postbundle implementation for all women having an operative vaginal birth or fully dilated cesarean of a term singleton cephalic nonanomalous fetus at Monash Health. Data were prospectively collected following bundle implementation from August 2022 to August 2024 and compared to a historical control cohort from November 2019 to November 2021, before the initial pilot of the bundle. We performed an interrupted time-series analysis to assess change in outcome trends over time. The primary outcome was a composite of neonatal morbidity, including Apgar score <7 at 5 minutes, cord lactate >8 mmol/L, severe birth trauma, intubation or cardiac compressions, therapeutic cooling, and neonatal intensive care unit admission. RESULTS:We included 2427 and 2914 births meeting the inclusion criteria in the postbundle and prebundle periods, respectively. Following bundle implementation, mothers were older (30.5±4.8 vs 30.1±4.9, P=.006), at a slightly later gestational age (39.5 [38.7, 40.3] vs 39.4 [38.5, 40.2], P=.003), it was more common for specialist obstetricians to attend the birth (56.1% vs 47.7%, P<.001), for ultrasound to be performed (55.8% vs 5.0%, P<.001), and for vaginal station to be low (54.1% vs 49.4%, P=.001), while it was less common to have occiput anterior position (71.2% vs 74.4%, P=.03) or missing documentation of clinical assessment (0.8% vs 3.4%, P<.001). There were no significant differences in rates of forceps, vacuum, or fully dilated cesarean overall; however, following implementation, there were more cesareans without attempted operative vaginal birth (9.5% vs 7.8%, P=.03), fewer births with ≥4 tractions or ≥2 cup detachments (5.8% vs 8.5%, P<.001), and less unsuccessful operative vaginal births (6.3% vs 8.3%, P=.005). There were no significant differences in the predefined neonatal composite morbidity (14.2% vs 13.9%, P=.80); however, there were significantly fewer neonates delivered in an unexpected position (0.7% vs 2.8%, P<.001), lower rates of severe neonatal birth trauma (1.3% vs 2.5%, P<.001), and lower rates of neonatal intensive care unit admissions (1.8% vs 2.7%, P=.02). There were higher rates of postpartum hemorrhage >1000 mL (17.6% vs 15.2%, P=0.02), but no differences in blood transfusions (3.7% vs 3.8%, P=0.96) or obstetrical anal sphincter injury (4.8% vs 5.4%, P=0.38). Interrupted time-series analysis demonstrated significant step reductions in fully dilated cesarean (-5.9%; 95% confidence interval, -11.77 to 0.11; P=.05), unsuccessful operative vaginal birth attempt (-5.1%; 95% confidence interval, -8.74 to 1.37; P=.008), and cesarean for unsuccessful operative vaginal birth (-2.4%; 95% confidence interval, -4.48 to 0.31; P=0.03), with no significant difference in neonatal or maternal morbidity. CONCLUSION:Implementation of a safety bundle for operative vaginal birth reduced the rates of unsuccessful operative vaginal birth and may reduce rates of neonatal birth trauma and neonatal intensive care unit admissions.

Objectives:This study aims at evaluating the role of Monash Online Simulated Clinical Examination (MONSCE, where students demonstrate their clinical consultation, problem solving and counselling skills in a virtual encounter) in relation to the Observed Structured Clinical Examination (OSCE).  The study addresses feasibility and application, student, tutor and Simulated Patient (SP) acceptance and also assessing future role in student assessment. Methods:Drawing on social constructivism, the study employed a qualitative methodology to explore perspectives of medical students, examiners and SPs across metropolitan Melbourne, rural Victoria and Malaysia. Data included individual interviews with nine examiners, eleven SPs, and three focus groups with students. Data were transcribed and thematically analysed using framework analysis. Results:Analysis demonstrated overlapping perspectives with five themes - fit for purpose assessment, focus on dynamics of online discourse, perceiving realism, readiness for practice and implications for future, with ongoing role in Telehealth. Readiness or preparation for practice was acknowledged through impact on student performance for progression, examiners' focus on assessment rigour replicating chaos and complexity of real life and SPs drew analogy with real-life clinical consultations. Conclusions:MONSCE assessments appear to be useful for student assessment of skills like history taking and clinical counselling. Their role was considered complementary to in-person clinical skills assessment but not replace the complexity of real life or replicate skills assessment of empathy, physical examination, and difficult communication, where in-person assessment may be preferred.

BACKGROUND:Operative birth is a known risk factor for negative birth experience, yet the modifiable factors that shape these experiences remain underexplored. AIM:This study examines factors associated with birth experience following operative second-stage birth, including operative vaginal birth (OVB) or fully dilated caesarean (FDCS). METHODS:We conducted a prospective mixed-methods study of women undergoing operative second-stage birth across four hospitals in one health network, in Melbourne Australia. A validated birth experience survey was administered, and responses were matched to clinical data. Logistic regression analysis identified factors associated with negative birth experience. Free-text survey responses were thematically analysed. FINDINGS:Of 2783 women who had an operative second-stage birth from July 2023 to March 2025, 402 (14.4 %) responded to the survey. Of those, 127 (31.6 %) scored < 25 indicating a negative experience. Negative experience was associated with prolonged second stage (odds ratio (OR) 2.00, 95 % confidence interval (CI) 1.26-3.20, p = 0.004), anal sphincter injury (OR 4.09, 95 % CI 1.59-11.00, p = 0.004) and postpartum haemorrhage (OR 2.01, 95 % CI 1.16-3.47, p = 0.013), while maternal age greater than 35 years (OR 0.41, 95 % CI 0.18-0.84, p = 0.020) and vacuum-assisted birth (OR 0.42 (0.22-0.77, p = 0.006) were protective. Qualitative analysis identified six overarching themes impacting birth experience: (1) preparation and expectations, (2) communication and care, (3) empowerment and control, (4) exhaustion and pain, (5) separation of the family unit, (6) physical and emotional safety. DISCUSSION AND CONCLUSION:Birth satisfaction is influenced by both clinical and contextual factors. Effective communication, emotional support, shared decision-making, and high-quality antenatal education are essential to improving maternal experience during operative birth.

BackgroundNeonatal resuscitation video review (NRVR) involves recording and reviewing resuscitations for education and quality assurance. Though NRVR has been shown to improve teamwork and skill retention, it is not widely used. We evaluated clinicians' experiences of NRVR to understand how NRVR impacts learning and can be improved.MethodsNeonatal Intensive Care Unit (NICU) clinicians with previous NRVR experience were recruited for individual semi-structured interviews. Using a social constructivist viewpoint, five researchers used thematic analysis to analyze participant responses.ResultsTwenty-two clinicians (11 nurses, 11 doctors) were interviewed. All participants expressed positive attitudes towards NRVR. Four themes were identified: (1) Learning from reality-exposure to real-life resuscitations was highly clinically relevant. (2) Immersive self-regulation-watching videos aided recall and reflection. (3) Complexities in learner psychological safety-all participants acknowledged viewing NRVR videos could be confronting. Some expressed fear of judgment from colleagues, though the educational benefit of NRVR superseded this. (4) Accessing and learning from diverse vantage points-NRVR promoted group discussion, which prompted participant learning from colleagues' viewpoints.ConclusionNeonatal clinicians reported NRVR to be an effective and safe method for learning and refining skills required during neonatal resuscitation, such as situational awareness and communication.ImpactNeonatal resuscitation video review is not known to be widely used in neonatal resuscitation teaching, and published research in this area is limited.Our study examined clinician attitudes towards an established neonatal resuscitation video review program.We found strong support for teaching using neonatal resuscitation video review among neonatal doctors and nurses, with key benefits including increased situational awareness and increased clinical exposure to resuscitations, while maintaining psychological safety for participants.The results of this study add evidence to support the addition of video review to neonatal resuscitation training.

Background: Operative vaginal birth (OVB) relies on effective teamwork to optimise outcomes. This study aims to explore providers’ perspectives of factors influencing safety and team functionality at OVB. Methods: This mixed methods study involved four maternity sites at Monash Health, Australia. Surveys sent to healthcare providers invited quantitative and qualitative appraisal of safety and team functionality at OVB. Semi-structured interviews further explored themes emerging from survey responses. Categorical survey data were compared between staff roles using Pearson’s chi-squared tests. Thematic analysis of free-text survey responses and interviews identified themes influencing safety and team functionality at OVB. Findings: We received 100 survey responses from obstetric (n=41), midwifery (n=52) and paediatric (n=7) staff, including senior (n=49) and junior (n=51) roles. Overall, 99% thought team communication should improve and 82% had witnessed practices outside protocol. Obstetric versus midwifery or paediatric staff were less likely to rate communication as low or very low quality (5% vs. 29%, p=0.010). Reporting being extremely or very confident to escalate concerns was more likely in obstetric versus midwifery or paediatric staff (49% vs.12%, p=0.003) and senior versus junior staff (44% vs. 10%, p=0.008). Five overarching themes impacted on team functionality at OVB; (1) Calibre of communication, (2) Preparation and risk assessment, (3) Leadership and interpersonal dynamics, (4) Transfer from Birth Unit to Operating Theatre, (5) Variation in clinical practice. Discussion: Some care providers perspectives of team functionality at OVB differed, with midwifery and paediatric staff more likely to report challenges with communication and were less empowered to escalate concerns. Training in factors impacting team functionality at OVB should be considered.

Medical and midwifery healthcare professionals have overlapping working profiles and yet have roles exclusive for each team. This chapter presents an overview of the interface of the two professions and highlights the current topical issues trending in this field. The medical and midwifery workforce both share a joint working space and client-base but their roles can be quite different while caring for the same woman. The challenges of pregnancy and birth complications require a high degree of collaboration and team work from the two professions. This chapter is coauthored by both medical and midwifery educational leads. We are located and knowledgeable from the Australian healthcare system; however, acknowledge many of the issues we raise will resonate with readers from other countries. Certain characteristics Medical and midwifery educationcharacteristicsmake obstetric medicine and midwifery unique in regard to the skill-sets required. Work-based placements Medical and midwifery educationwork-based placementsform the cornerstone of clinical learning. Although the curriculum for these respective professions enforces mandatory skills requirement, learners may struggle with presence of scant opportunities to learn from pregnant women. This may be especially due to the intimate nature of maternity care and occurrence of sudden unpredictable emergency pregnancy or birth-related complications. Creative ways of teaching complex skills like haptic procedures, and clinical decision-making in difficult situations, need to be provided. In this chapter, we describe the intrinsic challenges faced by learners of the medical and midwifery professions. We also address these learning issues by describing innovative initiatives to support medical and midwifery student preparation for practice.

Introduction/backgroundCourse evaluation in health education is a common practice yet few comprehensive evaluations of health education exist that measure the impact and outcomes these programs have on developing health graduate capabilities.Aim/objectivesTo explore how curricula contribute to health graduate capabilities and what factors contribute to the development of these capabilities.MethodsUsing contribution analysis evaluation, a six-step iterative process, key stakeholders in the six selected courses were engaged in an iterative theory-driven evaluation. The researchers collectively developed a postulated theory-of-change. Then evidence from existing relevant documents were extracted using documentary analysis. Collated findings were presented to academic staff, industry representatives and graduates, where additional data was sought through focus group discussions - one for each discipline. The focus group data were used to validate the theory-of-change. Data analysis was conducted iteratively, refining the theory of change from one course to the next.ResultsThe complexity in teaching and learning, contributed by human, organizational and curriculum factors was highlighted. Advances in knowledge, skills, attitudes and graduate capabilities are non-linear and integrated into curriculum. Work integrated learning significantly contributes to knowledge consolidation and forming professional identities for health professional courses. Workplace culture and educators’ passion impact on the quality of teaching and learning yet are rarely considered as evidence of impact.DiscussionCapturing the episodic and contextual learning moments is important to describe success and for reflection for improvement. Evidence of impact of elements of courses on future graduate capabilities was limited with the focus of evaluation data on satisfaction.ConclusionContribution analysis has been a useful evaluation method to explore the complexity of the factors in learning and teaching that influence graduate capabilities in health-related courses.

BACKGROUND:Frameworks in higher education can support strategic curriculum change in complex systems. The impact of these frameworks in achieving their stated purpose is less known. An interprofessional education (IPE) framework and related multi-activity curriculum designed to develop health profession graduates with the requisite skills for collaborative care, was introduced in a large university, across eleven health professions. OBJECTIVE:To determine the utility of an interprofessional framework and impact upon perceived work readiness for collaborative practice. METHOD:A multimethod design using the context, input, process, product (CIPP) evaluation model was selected taking a social constructivist theoretical stance. Data collection included staffing allocation to IPE, curriculum audit, and reflections from representatives of all health professions courses offered at the institution. Data was analyzed using framework analysis. PARTICIPANTS:Interviews or focus groups were undertaken with academic Faculty (n = 13), recent graduates (n = 24) and clinical supervisors/employers of recent graduates (n = 17). RESULTS:The framework assisted the systematic implementation of interprofessional curriculum across the different health courses at the university. Collaborative work-ready learning outcomes were identified in graduates where targeted curriculum had been implemented across all four domains of the framework. Gaps identified in framework implementation were consistent with gaps identified in graduate knowledge and skills related to collaborative practice. The combination of formal university-based IPE and informal workplace learning as part of clinical placements contributed to achieving the desired learning outcomes. CONCLUSIONS:These findings offer insights into the use of shared frameworks to drive specific learning activities related to collaborative practice.

Background Blended teaching combines traditional in-person components (simulation-based training and clinical-based placement) with online resources. Due to the COVID-19 pandemic, we modified our Women's Health Interprofessional Learning through Simulation (WHIPLS) program - to develop core obstetric and gynaecological skills - into a blended teaching program. There is limited literature reporting the observations of blended teaching on learning. Aims To qualitatively evaluate the blended teaching program and explore how it contributes to learning. Materials and Methods This study was performed at Monash University in Melbourne, Australia. A total of 98 medical students and 39 midwifery students participated. Data were collected by written survey and analysed by authors using a thematic analysis framework. Results Students reported that in-person teaching remains a vital aspect of their curriculum, contributing an averaged 63.2% toward an individual's learning, compared with online. Five substantial themes demonstrate how students learnt and maximised education opportunities using a blended teaching program: 'low-pressure simulation environments', 'peer-assisted learning', 'haptic learning', 'scaffolded learning' and 'the impact of online discourse'. Discussion In-person teaching remains a cornerstone of obstetric and gynaecological clinical skills education, of which interprofessional simulation and clinical-based placement are key components. Teaching via online discourse alone, is not sufficient to completely replace and provide comparable learning outcomes, but certainly plays an important role to prime students' learning and to maximise in-person opportunities and resources. Our study reveals key pedagogies of a blended (online and in-person) learning program, providing further evidence to support its ongoing utility as a feasible and warranted approach to learning.

BackgroundWe transitioned our obstetric neonatal emergency simulation (ONE-Sim) workshops to an online format during the COVID-19 pandemic. In this study, we evaluated key learning acquired by undergraduate medical and nursing students attending the online ONE-Sim workshops from a low- and middle-income country (LMIC).MethodsStudent perception of online workshops was collected using electronic questionnaires. Data was analysed using thematic analysis by employing the Community of Inquiry (CoI) framework.ResultsOne hundred sixty medical and nursing students who attended the online ONE-Sim workshops completed the questionnaires. There was evidence in the data to support all three aspects of the CoI framework-social, cognitive and teacher presence.ConclusionsThe use of the CoI framework helped to describe key learning from online interprofessional simulation workshops conducted for a LMIC.

Background Short-term medical mission (STMM) providers supplement healthcare delivery and education in low- and middle-income countries (LMIC). Despite numerous providers working in this space, the views of volunteers who contribute their time and skills to these programs are rarely sought. Method A qualitative study of 24 volunteers for Pangea Global Health Education (Pangea) was undertaken using semi-structured interviews to better understand their perspectives on program design and delivery, personal and professional outcomes of their volunteer experiences and the resulting implications for STMM program design. An inductive thematic analysis of their responses was completed. Social constructionist theory was utilised to contextualise themes and implications for program design. Results Participants highlighted the importance of co-creation with local learners and staff, the necessity to understand clinical context and the importance of relating to culture in the advancement of patient care. They reported personal growth, including a better understanding of others, and identifying commonalities between people. Professionally, participants reported learning from their colleagues, including new medical content, as well as refining their teaching practices. They also reported learning from those they taught and respecting the resourcefulness of medical and nursing staff working in LMIC. Conclusion STMM providers may benefit from co-creation with their learners in the development of health professional education programs. A deep understanding of local context and culture provides for a richer learning environment and enables sustainable long-term program delivery. Utilising a social constructionist framework enables a better understanding of cultural barriers, which inhibit group learning, including the tendency to maintain hierarchical divides; addressing these will allow for optimised patient care.

Obstetric and gynaecology undergraduate training is an intense time for learners as they encounter various health conditions related to women's health and also learn about pregnancy care and birth. The experience is directed to familiarise students with basic clinical management of gynaecological conditions, also develop communication and related core examination and procedural skills. Similarly, midwifery training encompasses independent care of low-risk pregnant women and assist in care of high-risk pregnancy in partnership with obstetricians. Although its necessary to acquaint most learners with core clinical skills in obstetrics and gynaecology, learning opportunities on patients can be limited, due to the intrusive nature of women's health examination. Simulation Based Education (SBE) can facilitate learning hands-on clinical examination and procedural skills, using realistic part-task and high-fidelity simulators prior to approaching patients. This can apply to both medical and midwifery undergraduate training, further creating opportunities for professional interaction and shared learning space to facilitate interprofessional education. IPE has been shown to improve professional relationships in practicing clinicians. This learning pedagogy can be applied in the undergraduate setting as well, to decrease risk of conflict and appreciate roles of other interprofessional staff in future clinical practice. In this chapter we highlight some challenges faced by medical and midwifery undergraduates in their learning from a global perspective. We also describe some teaching and learning initiatives that can be applicable across various settings of obstetrics, gynaecology medical undergraduate and midwifery teaching with relevant case studies to facilitate new graduates preparedness for practice.

Background: Pulse diagnosis (wrist pulse signal) is a well-known traditional technique used for a health examination. It has the potential to detect cardiac and non-cardiac diseases. Objective: A study was conducted to investigate human emotions using wrist pulse signal assessment. The aim was to categorize anxiety, boredom, physical pain, and reference state by processing and analysis of acquired signals. Method: A protocol was designed to induce emotions. Data were acquired from 24 healthy volunteers. Signals were processed and further analyzed using paired t-test and Analysis of Variance (ANOVA). Machine learning algorithms, Linear Discriminant Function (LDF), Quadratic Discriminant Function (QDF), and Support Vector Machine using kernel Gaussian radial basis function (RBF-SVM) were used to evaluate significant features and classify the emotions. Results: Computing significant plus ranked features performed better over randomly selected features for pairwise emotion classification. Here, the QDF classifier outperforms LDF. Additionally, ANOVA validated the effectiveness of statistically prominent features to classify emotional states. Ratio_Pulse_Strength, total_power, Spectral Entropy, and meancd5 came out as the four most significant features to classify the emotion "Anxiety ", "Boredom ", "Pain ", and "Reference " with positive prediction rate of 100%, 73%, 100%, and 86% respectively using RBF-SVM in the user-independent model. Conclusion: Previously, WPS has been used mainly to detect physical abnormality in the human body. The results endorse the potential of user-independent human emotion detection using a wrist pulse signal. The present work was focusing on a few emotional states. Results are encouraging and may be well applied to many more states. (C) 2021 AGBM. Published by Elsevier Masson SAS. All rights reserved.

During the COVID-19 pandemic, universities across the world transitioned rapidly to remote education. Engaging with a curriculum that has been transitioned from in-person to remote education mode is likely to impact how students and educators adapt to the changes and uncertainties caused by the pandemic. There is limited knowledge about individual differences in students' and educators' adaptability to remote education in response to the pandemic. This paper explored healthcare students' and educators' adaptability experiences to remote education. Drawing on pragmatism, a convergent mixed-methods design was adopted. Data were collected between May and August in 2020 using an online survey, followed by interviews with students and educators of five large health courses at an Australian research-intensive University. Data included 476 surveys and seven focus group interviews with 26 students, and 95 surveys and 17 individual interviews with educators. Results were interpreted through an integration of quantitative and qualitative elements from student and educator experiences. Findings indicated that students were less adaptable than educators. Whilst remote learning was less appealing than in-person learning, some students adapted well to the new learning environment. Limited social learning, transmissive pedagogy, and lack of technical and non-technical skills were identified as factors that impacted upon the experience of students and educators. Navigating the challenges associated with remote education provided students and educators with a unique opportunity to improve adaptability-an attribute critical for future uncertainties in healthcare practice.

INTRODUCTION:Situation awareness (SA) training is a vital part of healthcare training, and opportunities to provide SA training to healthcare workers are limited in low- and middle-income countries. We aimed to analyze undergraduate medical and nursing students' perception of their understanding of SA through an interprofessional obstetric neonatal emergency simulation workshop (ONE-Sim) and subsequently evaluate their perceived changes in SA understanding using the Endsley model ( Hum Factors 1995;37(1):32-64). METHODS:Feedback on SA before and after the workshop was collected through questionnaire-based surveys. Thematic analysis was performed, with themes emerging from an inductive analysis followed by a deductive analysis using the Endsley model. RESULTS:The themes emerging from the inductive analysis included environmental awareness, evolving knowledge, skill development, and applicability to practice. These aligned with the 3 levels of SA in the Endsley model in the deductive analysis suggesting that participants transformed their perception, comprehension, and projection of SA after the workshop. CONCLUSION:Simulation-based education enhanced SA perception in obstetric and neonatal emergencies for medical and nursing students in a low- and middle-income country, and the Endsley model is a feasible framework to measure learner perceived changes in SA understanding through simulation-based education.

Objectives To explore student perceptions of learning and interprofessional aspects of obstetric and neonatal emergencies through online simulation-based workshops. Methods This qualitative study was conducted at Monash University, Australia. Data were obtained from six separate online Obstetric Neonatal Emergency Simulation workshops held between May 2020 and August 2021. A total of 385 students attended and were invited to participate in the study by completing an online survey two-three weeks later. Of the attendees, 144 students completed the survey (95 medical, 45 midwifery), equating to a response rate of 37%. Survey responses were downloaded from online survey platform and separated into medical and midwifery responses. Thematic analysis of data was performed using a coding framework, resulting in development of themes and subthemes. Results Main themes were adaptability, connectivism, preparedness for practice, experiential learning, learning through modelling and dynamics of online interaction. Students reported that online workshop was a useful alternative method to experience simulation-based learning, increase their readiness for clinical practice and foster positive interprofessional relationships. Consistent with existing literature evaluating similar in-person programs, midwifery students were most interested in interprofessional interaction (predominant theme: dynamics of online interaction), whilst medical students were more concerned with developing clinical skills (predominant themes: learning through modelling, experiential learning). Conclusions Online learning may be a useful and convenient way of delivering interprofessional simulation-based education during the pandemic, in remote areas and as an adjunct to in-person teaching. Future studies should evaluate the impact of online learning with a mixed methods study and in comparison, to in-person programs.