Cent Eur J Nurs Midw. X:X

The effect of a leadership and teamwork experiential learning module on managing shoulder dystocia with high-fidelity simulation training: a randomized controlled study

Antonis Theofilidis¹, Dimitrios Papoutsis^1,2, Nikoleta Chatzipanagiotidou¹, Chara Tzavara³

¹ Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani, Greece

² Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Apley Castle, Telford, United Kingdom

³ Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Aim: To explore the effect of leadership and teamwork training when managing shoulder dystocia.

Design: Randomized-controlled-trial.

Methods: We randomized midwifery students attending a one-day workshop into groups A (intervention) and B (controls). Shoulder dystocia training and assessment was performed with a high-fidelity computerized birthing-simulator. The intervention involved a two-hour leadership and teamwork experiential learning module. All students participated in a pre-training assessment and theoretical and practical training and completed a post-training assessment. Group A students received the intervention following their theoretical and practical training, but prior to the final post-training assessment.

Results: Fifty-one students participated (mean age 21.9 ± 3.1 years); 25 were randomly assigned to group A and 26 to group B. Before training, both groups showed similarly low baseline scores for successful deliveries, maneuver performance, confidence, communication, teamwork, and leadership skills. Students in both groups achieved similarly high post-training scores for successful deliveries (> 92%), maneuvers (> 16/20), and confidence (8/10). Compared with controls, participants receiving the intervention showed a trend toward higher teamwork (3.1 ± 2.4 vs 2.1 ± 2.1; p = 0.08) and leadership scores (3.8 ± 2.7 vs 2.6 ± 2.3; p = 0.08) at the end of the workshop.

Conclusion: Our findings support the inclusion of a teamwork and leadership training module during shoulder dystocia simulation.

Keywords: high-fidelity simulation, leadership, parturition, shoulder dystocia, teamwork

Received: August 17, 2025; Revised: January 9, 2026; Accepted: January 10, 2026; Prepublished online: January 16, 2026