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Evidence of effectiveness


Find out more about how PROMPT training can improve clinical outcomes in your labour and birthing unit. The publications listed below highlight the benefits of introducing PROMPT training. Click on the publication titles to read an abstract. 

You can read more about PROMPT training internationally and the PROMPT Maternity Foundation at


Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation. Liberati EG, Tarrant C, Willars J The SCALING Authorship Group, et al. BMJ Quality & Safety Published Online: 25 September 2020. 

Clinical negligence costs: taking action to safeguard NHS sustainability. Yau C, Leigh BLiberati E, Punch D, Dixon-Woods M, Draycott T. BMJ. 2020 368.




Effects of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-edge design randomised controlled trial. Lenguerrand E, Winter C, Siassakos D, Maclennan G, Innes K, Lynch P, Cameron A, Crofts J, McDonald A, Mccormack K, Forrest M, Norrie Bhattacharya S, Draycott T BMJ Qual Saf. 2019 Jul 13. pii: bmjqs-2018-008625. doi: 10.1136/bmjqs-2018-008625. [Epub ahead of print]


How to be a very safe maternity unit: An ethnographic study. Liberatia EG, Tarrant C, Willars J, Draycott T, Winter C, Chew S, Dixon-Woods M. Social Science & Medicine 2019;223: 64-72.

The effects of interactive training of healthcare providers on the management of life-threatening emergencies in hospital. Merriel A, Ficquet J, Barnard K, Kunutsor SK, Soar J, Lenguerrand E, Caldwell DM, Burden C, Winter C, Draycott T, Siassakos D. Cochrane Database Syst Rev. 2019; 9: CD012177. doi: 10.1002/14651858.CD012177.pub2.


Exploring standardisation, monitoring and training of medical devices in assisted vaginal birth studies: protocol for a systematic review. Hotton EJ, Renwick S, Barnard K, Lenguerrand E, Wade J, Draycott T, Crofts JF, Blencowe NS.
BMJ Open. 2019 Apr 14;9(4).

Skills training for operative vaginal birth.Hotton E, O'Brien S, Draycott TJ. Best Pract Res Clin Obstet Gynaecol. 2019 Apr;56:11-22.

Delivering high reliability in maternity care: in-situ simulation as a source of organisational resilience. Macrae C, Draycott T. Safety Science 2019; 117: 490-500.


Rapid cycle method for local adaptation of an obstetric emergencies training program. Ghag K, Winter C, Bahl R, Lynch M, Bautista N, Ilagan R, Draycott TJ. Int J Gynaecol Obstet. 2018; 141: 393–8.


THISTLE: trial of hands-on interprofessional simulation training for local emergencies: a research protocol for a stepped-wedge clustered randomised controlled trial. Lenguerrand E, Winter C, Innes K, MacLennan G, Siassakos D, Lynch P, Cameron A, Crofts J, McDonald A, McCormack K, Forrest M, Norrie J, Bhattacharya S, Draycott T; Thistle groupBMC Pregnancy Childbirth 2017; 17(1):294.

Cost-effectiveness of simulation-based team training in obstetric emergencies (TOSTI study). van de Ven J, van Baaren GJ, Fransen AF, van Runnard Heimel PJ, Mol BW, Oei SG. Eur J Obstet Gynecol Reprod Biol. 2017; 216:130-137


PROMPT in New Zealand. Sowter M. O and G Magazine 2017; 19(2):57-9.


The cost of local, multi-professional obstetric emergencies training. Yau CW, Pizzo E, Morris S, Odd DE, Winter C, Draycott TJActa Obstet Gynecol Scand. 2016; 95(10):1111-9. 


Identifying deteriorating patients through multidisciplinary team training. Merriel A, van der Nelson H, Merriel S, Bennett J, Donald F, Draycott T, Siassakos DAm J Med Qual. 2016; 31(6):589-595.

Team Training and Institutional Protocols to Prevent Shoulder Dystocia Complications. Smith S. Clinical Obstetrics and Gynecology 2016; 59(4):830–840.


Multi-professional training for obstetric emergencies in a U.S. hospital over a 7-year interval: an observational study.

Weiner CP, Collins L, Bentley S, Dong Y, Satterwhite CLJ Perinatol. 2016 Jan; 36(1):19-24.

Prevention of brachial plexus injury-12 years of shoulder dystocia training: an interrupted time-series study.

Crofts JF, Lenguerrand E, Bentham GL, Tawfik S3, Claireaux HA, Odd D, Fox R, Draycott TJBJOG.2016; 123(1):111-8.


Myths and realities of training in obstetric emergencies. Draycott TJ, Collins KJ, Crofts JF, Siassakos D, Winter C, Weiner CP, Donald F. Best Pract Res Clin Obstet Gynaecol. 2015; 29(8):1067-76.


Team training for safer birth. Cornthwaite K, Alvarez M, Siassakos DBest Pract Res Clin Obstet Gynaecol. 2015; 29(8):1044-57.

The role of insurers in maternity safety. Draycott T, Sagar R, Hogg SBest Pract Res Clin Obstet Gynaecol. 2015; 29(8):1126-31


Impact of introducing Practical Obstetric Multi-Professional Training (PROMPT) into maternity units in Victoria, Australia. Shoushtarian M, Barnett M, McMahon M, Ferris J. BJOG 2014; 121(13): 1710-8.

5-year experience with PROMPT (PRactical Obstetric Multidisciplinary Training) reveals sustained and progressive improvements in obstetric outcomes at a US hospital. Weiner C, Samuelson L, Collins L, Satterwhite C. American Journal of Obstetrics and Gynecology 2014; 210(1): S40.

Multi-professional team simulation training, based on an obstetric model, can improve teamwork in other areas of health care. Van der Nelson HA, Siassakos D, Bennett J, Godfrey M, Spray L, Draycott T, Donald F. Am J Med Qual. 2014; 29(1):78-82.



Reducing risk in maternity by optimising teamwork and leadership: an evidence-based approach to save mothers and babies.  Cornthwaite K, Edwards S, Siassakos D. Best Practice & Research. Clinical Obstetrics & Gynaecology 2013; 27(4):571-81.

Retention of factual knowledge after practical training for intrapartum emergencies. Croft JF, Fox R, Draycott T, Winter C, Hunt LP, Akande VA. International Journal of Obstetrics and Gynaecology 2013; 123(1):81-5.


What makes maternity teams effective and safe? Lessons from a series of research on teamwork, leadership and team training. Siassakos D, Fox R, Bristowe K, Angouri J, Hambly H, Robson L, Draycott TJActa Obstet Gynecol Scand. 2013; 92(11):1239-43.

Emergency obstetric simulation training: how do we know where we are going, if we don't know where we have been?

Calvert KL1, McGurgan PM, Debenham EM, Gratwick FJ, Maouris P. Aust N Z J Obstet Gynaecol. 2013; 53(6):509-16.


Teamwork for Clinical Emergencies: Interprofessional Focus Group Analysis and Triangulation With Simulation.
Bristowe K, Siassakos D, Hambly H, Angouri J, Yelland A, Draycott TJ, Fox R. Qual Health Res. Qual Health Res. 2012; 22(10):1383-94.


Medical simulation for professional development-science and practice. Fox R, Walker JJ, Draycott TJ. BJOG 2011; 118 Suppl 3:1-4.

Evaluating the impact of simulation on translational patient outcomes. McGaghie WC, Draycott TJ, Dunn WF, Lopez CM, Stefanidis D. Simul Healthc. 2011; 6 Suppl:S42-7.


Surgical skills training: does it improve clinical outcome?  Draycott T, Barnfield S. Resuscitation 2011; 82(8):973.

Team communication with patient actors: findings from a multisite simulation study. Siassakos D, Bristowe K, Hambly H, Angouri J, Crofts JF, Winter C, Hunt LP, Draycott TJ. Simul Healthc. 2011; 6(3):143-9.

The use of simulation to teach clinical skills in obstetrics. Cass GK, Crofts JF, Draycott TJ. Semin Perinatol. 2011; 35(2):68-73.

Improving collaboration in maternity with interprofessional learning. Siassakos D, Marshall L, Draycott T. J Midwifery Womens Health 2011; 56(2):183.

Measuring the impact of simulation-based training on patient safety and quality of care: Lessons from maternity. Siassakos D, Draycott T. Resuscitation. 2011; 82(6):782.

Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study. Siassakos D, Bristowe K, Draycott TJ, Angouri J, Hambly H, Winter C, Crofts JF, Hunt LP, Fox R. BJOG  2011; 118(5):596-607.

Practical simulation training for maternity care-where we are and where next. Crofts JF, Winter C, Sowter MC. BJOG. 2011; 118 Suppl 3:11-6.

Training to reduce adverse obstetric events with risk of cerebral palsy. Siassakos D, Fox R, Draycott T. Am J Obstet Gynecol. 2011; 204(5):e15-6.

The management of a simulated emergency: better teamwork, better performance. Siassakos D, Fox R, Crofts JF, Hunt LP, Winter C, Draycott TJ. Resuscitation 2011; 82(2):203-6.

Attitudes toward safety and teamwork in a maternity unit with embedded team training. Siassakos D, Fox R, Hunt L, Farey J, Laxton C, Winter C, Draycott T. Am J Med Qual. 2011; 26(2):132-7.

Sustaining simulation training programmes--experience from maternity care. Ayres-de-Campos D1, Deering S, Siassakos D BJOG 2011; 118 Suppl 3:22-6.


Exploratory randomized controlled trial of hybrid obstetric simulation training for undergraduate students. Siassakos D, Draycott T, O'Brien K, Kenyon C, Bartlett C, Fox R. Simul Healthc. 2010; 5(4):193-8.

Quality improvement demands quality measurement. Draycott T, Sibanda T, Laxton C, Winter C, Mahmood T, Fox R. BJOG. 2010; 117(13):1571-4.


More to teamwork than knowledge, skill and attitude. Siassakos D, Draycott TJ, Crofts JF, Hunt LP, Winter C, Fox R. BJOG. 2010; 117(10):1262-9.


Content analysis of team communication in an obstetric emergency scenario. Siassakos D, Draycott T, Montague I, Harris M. J Obstet Gynaecol. 2009; 29(6):499-503.

PROMPT education and development: saving mothers' and babies' lives in resource poor settings. Sibanda T, Crofts JF, Barnfield S, Siassakos D, Epee MJ, Winter C, Draycott T. BJOG 2009; 116(6):868-9.

The active components of effective training in obstetric emergencies. Siassakos D, Crofts JF, Winter C, Weiner CP, Draycott TJ. BJOG. 2009;116(8):1028-32.

Retrospective cohort study of diagnosis-delivery interval with umbilical cord prolapse: the effect of team training.
Siassakos D, Hasafa Z, Sibanda T, Fox R, Donald F, Winter C, Draycott T. BJOG 2009; 116(8):1089-96.


Hospital, simulation center, and teamwork training for eclampsia management: a randomized controlled trial. Ellis D, Crofts JF, Hunt LP, Read M, Fox R, James M. Obstet Gynecol. 2008; 111(3):723-31.

Observations from 450 shoulder dystocia simulations: lessons for skills training. Crofts JF, Fox R, Ellis D, Winter C, Hinshaw K, Draycott TJ. Obstet Gynecol. 2008; 112(4):906-12.

Improving neonatal outcome through practical shoulder dystocia training. Draycott TJ, Crofts JF, Ash JP, Wilson LV, Yard E, Sibanda T, Whitelaw A. Obstet Gynecol. 2008; 112(1):14-20.


Patient-actor perception of care: a comparison of obstetric emergency training using manikins and patient-actors.
Crofts JF, Bartlett C, Ellis D, Winter C, Donald F, Hunt LP, Draycott TJ. Qual Saf Health Care. 2008;17(1):20-4.

Management of shoulder dystocia: skill retention 6 and 12 months after training. Crofts JF, Bartlett C, Ellis D, Hunt LP, Fox R, Draycott TJ. Obstet Gynecol. 2007; 110(5):1069-74.

Change in knowledge of midwives and obstetricians following obstetric emergency training: a randomised controlled trial of local hospital, simulation centre and teamwork training. Crofts JF, Ellis D, Draycott TJ, Winter C, Hunt LP, Akande VA. BJOG 2007; 114(12):1534-41.

Pattern and degree of forces applied during simulation of shoulder dystocia. Crofts JF, Ellis D, James M, Hunt LP, Fox R, Draycott TJ. Am J Obstet Gynecol. 2007; 197(2):156.e1-6.



Training for shoulder dystocia: a trial of simulation using low-fidelity and high-fidelity mannequins. Crofts JF, Bartlett C, Ellis D, Hunt LP, Fox R, Draycott TJ.Obstet Gynecol 2006; 108(6):1477-85.

Does training in obstetric emergencies improve neonatal outcome? Draycott T, Sibanda T, Owen L, Akande V, Winter C, Reading S, Whitelaw A. BJOG 2006; 113(2):177-82.


Shoulder dystocia training using a new birth training mannequin. Crofts JF, Attilakos G, Read M, Sibanda T, Draycott TJ. BJOG 2005; 112(7):997-9.

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