The Electronic Fetal Monitoring (EFM) Series
Strengthening EFM competency is vital in improving
obstetrics care quality and reducing risk. The EFM
courseware series is concise, yet designed to ensure
maximum knowledge acquisition and retention, as well as
clinical reasoning assessment, through the creative use of
virtual simulation. It has been developed to engage
learners quickly—allowing each learner to experience
real-life situations, make realistic decisions, and experience
the outcomes of those decisions.
The EFM modules are comprised of:
A Standardized EFM Knowledge Pre-Assessment
Module 1 – Introduction to EFM terminology
This module covers the terminology related to EFM.
Consistent use of this terminology is necessary in the
assessment of fetal oxygenation and recognition of fetal
hypoxic state. EFM evaluation enables providers to
understand and implement the steps necessary to
prevent potential harm or neurologic injury to the fetus.
At the completion of the module the participant will be
able to discuss the elements of uterine activity assessment,
describe the components of fetal heart rate patterns, and
explain the correlation between fetal heart rate patterns
and fetal acidemia.
Module 2 – EFM Beginner
This module covers the three-tiered classification system
related to the recognition of ongoing fetal status
developed by the National Institute of Child Health and
Human Development (NICHD) in April 2008 in
partnership with The American Congress of
Obstetricians and Gynecologists (ACOG), the
Association of Women’s Health, obstetric and neonatal
nurses and the Society for Maternal Fetal Medicine. The
most effective way for the perinatal team to
communicate about the fetal tracing is for all providers
to utilize the standardized classification system
recommended in the NICHD guidelines.
At the completion of the module the participant will be
able to define the categories of fetal heart tracings, state
the components of Category I, Category II and Category
III fetal heart tracings, and identify clinical factors affecting
the fetal heart tracing.
Module 3 – EFM Intermediate
This module addresses the appropriate treatment of the
fetus and mother based upon fetal heart tracing
interpretations. Knowing what to do with a particular fetal
heart tracing is critical to the clinical outcome.
At the completion of the module the participant will be
able to interpret fetal heart tracings, recognize the
physiologic factors which play a role in fetal heart tracing,
describe the components of intra-utero fetal resuscitation,
and demonstrate appropriate communication techniques
when responding to a concerning fetal heart tracing.
Module 4 – EFM Advanced
This module addresses the differentiation between
Categories II and III fetal heart tracings and the perinatal
teamwork and communication needed for the
appropriate treatment of the patient, including the
escalation of care, when required.
At the completion of the module the participants will be
able to describe the differences between Categories II and
III fetal heart tracings, demonstrate appropriate
communication techniques regarding Category III tracings,
and identify when it is necessary to escalate care in
response to fetal heart tracings.
An additional learning tool also available is a related,
immersive EFM interpretation game. This serious game
enables learners to be evaluated on their interpretation
and decision making in the simulated setting of a labor
and delivery unit. It is an optional component that
integrates with the product’s mandatory micro-
simulations. The educational methodology around virtual
simulation/gaming has been found to be as effective for
use as a high fidelity simulation lab.
The United States has the highest maternal mortality rate of any high
resource country—and it’s the only country outside of Afghanistan and
Sudan where the rate is rising.
-Alliance for Innovation on Maternal Health
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