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Table 2 Study characteristics

From: Training and expertise in undertaking assisted vaginal delivery (AVD): a mixed methods systematic review of practitioners views and experiences

Author & date

Title

Resource setting

Country

Setting

Population

Participants

Design

Methods

QA grade

Al Wattar et al. 2017 [16]

Training on Kielland’s forceps: A survey of trainees’ opinions

HIC

England

Regional (not national)

Specialist trainee obstetricians

87/172 participated that were eligible

Quantitative

Cross-sectional survey

C

Alexander et al. 2001 [17]

An evaluation by focus group and survey of a course for Midwifery Ventouse Practitioners

HIC

England

National

Midwives who had completed ventouse advanced training

n = 8 focus group n = 18 survey (100% response rate)

Mixed methods

Focus group followed by survey

B

Bahl et al. 2008a [18]

Qualitative analysis by interviews and video recordings to establish the components of a skilled low-cavity non-rotational vacuum delivery

HIC

UK

Two university teaching hospitals: Dundee & Bristol

Obstetricians and midwives

n = 10 obstetricians, n = 8 midwives

Qualitative

Interviews, vignettes, video recordings

A/B

Bahl et al. 2010a [19]

Non-technical skills for obstetricians conducting forceps and vacuum deliveries: qualitative analysis by interviews and video recordings

HIC

UK

Two university teaching hospitals: Dundee & Bristol

Obstetricians and midwives

n = 10 obstetricians, n = 8 midwives

Qualitative

Interviews, vignettes, video recordings

A/B

Bahl et al. 2013a [20]

Qualitative analysis by interviews and video recordings to establish the components of a skilled rotational forceps delivery

HIC

UK

Two university teaching hospitals: Dundee & Bristol

Obstetricians and midwives

n = 10 obstetricians, n = 8 midwives

Qualitative

Interviews, vignettes, video recordings

A/B

Bahl et al. 2013a [21]

Decision-making in operative vaginal delivery: when to intervene, where to deliver and which instrument to use? Qualitative analysis of expert clinical practice

HIC

UK

Two university teaching hospitals: Dundee & Bristol

Obstetricians and midwives

n = 10 obstetricians, n = 8 midwives

Qualitative

Interviews, vignettes, video recordings

A/B

Biringer et al. 2019 [22]

Enhanced skills training in family medicine maternity care: Cross-sectional study of graduates’ experiences

HIC

Canada

National

Graduates of family medicine enhanced skills programs (2004–2014)

87/233 participated that were eligible

Quantitative

Cross-sectional questionnaire

C

Bofill et al. 1996a [23]

Forceps and vacuum delivery: A survey of North American residency programs

HIC

US

National

Residents (trainee O&G)

210/291 participated that were eligible

Quantitative

Purposive survey

C/D

Bofill et al. 1996b [24]

Operative Vaginal Delivery: A Survey of Fellows of ACOG

HIC

US

National

Fellow obstetricians

597/1600

Quantitative

Randomised survey

C/D

Chinnoock et al. 2009 [25]

An anonymous survey of registrar training in the use of Kjelland’s forceps in Australia

HIC

Australia

National

Registrar obstetricians (trainee)

197/303 participated that were eligible

Quantitative

Purposive survey

C/D

Crosby et al. 2017 [26]

An international assessment of trainee experience, confidence, and comfort in operative vaginal delivery

HIC

Ireland & Canada

International comparison

Trainee obstetricians

31/56 eligible Canadian trainees, 21/48 eligible Irish trainees

Quantitative

Purposive survey

C/D

Devjee 2015 [27]

A survey of health professionals on the current use of forceps / ventouse and skills training for operative vaginal delivery

UMIC

South Africa

Provincial

Healthcare workers (includes Interns /Medical Officers/ Community service officers /Registrars /Specialists)

197/250 (30 excluded for incompleteness) n = 15 Interns, n = 71 medical officers, n = 29 community service officers, n = 25 registrars, n = 15 specialists

Quantitative

Purposive survey

C/D

Eichelberger et al. 2015 [28]

Training needs in operative obstetrics for maternal–fetal medicine fellows

HIC

US

Regional (not national)

First year maternal–fetal medicine (MFM) fellows

86/100 participated that were eligible

Quantitative

Purposive survey

C

Evans et al. 2009 [29]

Where there is no obstetrician – increasing capacity for emergency obstetric care in rural India: An evaluation of a pilot program to train general doctors

LMI

India

Two sites Surat (Gujarat) and Jaipur (Rajasthan)

Medical officers

n = 17

Qualitative

Pilot study evaluation: program documents, facility observation, data abstraction at the facilities, and from semi-structured interviews with key informants (program and government staff, regional and international experts, trainees and trainers

B/C

Fauveau 2009 [30]

Is vacuum extraction still known, taught and practiced? A worldwide KAP survey

Low- middle

International study across Sub-Saharan Africa, Latin America and Caribbean Asia, the Pacific, Arab States, and Middle East Central Asia

International

Obstetricians, midwives, or public health experts specializing in maternal health

111/121 countries investigated

Quantitative

Rapid Knowledge—Attitude—Practice (KAP) survey

D

Friedman et al. 2020 [31]

Resident Attitudes Towards Caesarean Delivery in Canadian Obstetrics and Gynaecology Residency Programs

HIC

Canada

National

Residents (trainee O&G)

160/501 participated that were eligible

Quantitative

Cross-sectional purposive survey with open text option

B

Hamza et al. 2020 [32]

Vaginal operative delivery in Germany: a national survey about experience and self-reported competency

HIC

Germany

National

Residents (trainee), specialists and consultants

n = 653

Quantitative

Survey

B

Hankins et al. 1999 [33]

Forceps and vacuum delivery: Expectations of residency and fellowship training program directors

HIC

North America

National

Residents (trainee) and fellows

219/354

Quantitative

Purposive survey

C

Healyand Laufe 1985 [34]

Survey of obstetric forceps training in North America 1981

HIC

North America

National residency programs

Chairmen of programs

108/144 participated that were eligible

Quantitative

Purposive survey

C

Hodges et al. 2015b [35]

Learning from Experience: Development of a Cognitive Task-List to Assess the Second Stage of Labour for Operative Delivery

HIC

Canada

Three large teaching hospitals in Toronto

Obstetricians identified as skilled

n = 20

Qualitative

Vignettes, video recordings, interviews, Delphi method

B/C

Powell et al. 2007 [36]

Vacuum and forceps training in residency: experience and self-reported competency

HIC

US

National

Chief residents (senior trainees)

n = 238 (20% of eligible participants) in first survey, n = 269 (23% of eligible participants) in second survey

Quantitative

Purposive survey repeated 1 year later due to low response rate in survey1

C

Ramphul et al. 2012 [37]

Strategies to enhance assessment of the fetal head position before instrumental delivery: a survey of obstetric practice in the United Kingdom and Ireland

HIC

UK & Ireland

International comparison

Obstetricians working in CLUs

323/423 participated that were eligible

Quantitative

Purposive survey with open text option

B

Robson and Pridmore. 1999 [38]

Have Kielland Forceps Reached Their ‘Use By’ Date?

HIC

Australia

One state (South Australia)

Obstetricians

23/29 participated that were eligible

Quantitative

Purposive survey

D

Rose et al. 2019 [39]

Forceps-assisted vaginal delivery: the landscape of obstetrics and gynecology resident training

HIC

US

National

Residents (trainees)

434/5061 participated that were eligible

Quantitative

Purposive survey

C

Sánchez del Hierro et al. 2014 [40]

Are recent graduates enough prepared to perform obstetric skills in their rural and compulsory year? A study from Ecuador

UMIC

Ecuador

Rural health centres in Southern Ecuador

Recently graduated medical doctors during their compulsory year of rural practice

90/92 participated that were eligible

Quantitative

Purposive survey

B

Sarangapani et al. 2018 [41]

Video-Based Teaching in Patient and Instrument Selection for Operative Vaginal Deliveries

HIC

Canada

One university site

Residents (trainees)

25/31 participated that were eligible-qualitative arm

MM overall, but qual data only to be used

Focus groups following training session

B

Saunier et al. 2015 [42]

French residents' training in instrumental deliveries: A national survey

HIC

France

National

Residents (1st years were excluded)

263/758 participated that were eligible

Quantitative

Purposive survey

C/D

Simpson et al. 2015b [43]

Learning From Experience: Development of a Cognitive Task List to Perform a Safe and Successful Non-Rotational Forceps Delivery

HIC

Canada

Three large teaching hospitals in Toronto

Obstetricians identified as skilled

n = 17

Qualitative

Vignettes, video recording analysis

B/C

Smith 1991 [44]

GP trainees' views on hospital obstetric vocational training

HIC

UK

National

General practitioner trainees

765/1019 participated that were eligible

Quantitative

Randomised survey

C/D

Tang et al. 2012 [45]

Impact of introducing consultant resident on-call in a District General Hospital

HIC

England

One hospital site

Consultants, junior trainees and midwives

n = 17 (unclear how many of each professional group)

Mixed methods

Retrospective study and interviews

C/D

Wilson and Casson 1990 [46]

Babes in the Woods: Teaching the Use of the Vacuum Extractor

HIC

Canada

One hospital site

Family physicians

n = 23

Quantitative

Retrospective audit and survey (survey data to be used)

C

  1. aSame study different research questions reported in the separate publications
  2. bSame study different research questions reported in the separate publications